Provider Demographics
NPI:1437101896
Name:TRI COUNTY MEDICAL SUPPLY INC
Entity Type:Organization
Organization Name:TRI COUNTY MEDICAL SUPPLY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARIETHA
Authorized Official - Middle Name:L
Authorized Official - Last Name:MORALES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-961-5164
Mailing Address - Street 1:6151 MIRAMAR PKWY
Mailing Address - Street 2:SUITE 105
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33023-3970
Mailing Address - Country:US
Mailing Address - Phone:954-961-5164
Mailing Address - Fax:
Practice Address - Street 1:6151 MIRAMAR PKWY
Practice Address - Street 2:SUITE 105
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33023-3970
Practice Address - Country:US
Practice Address - Phone:954-961-5164
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1312399332B00000X
FL3203993332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Not Answered332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1312399OtherHME LICENSE
FL3203993OtherMEDICAL OXYGEN LICENSE
FL1312399OtherHME LICENSE