Provider Demographics
NPI:1437241726
Name:SANDY'S DISTRIBUTION, CORP.
Entity Type:Organization
Organization Name:SANDY'S DISTRIBUTION, CORP.
Other - Org Name:JERY MEDICAL SUPPLIES, INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:R
Authorized Official - Last Name:MILLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:3305-325-8771
Mailing Address - Street 1:1399 NW 17 AVE
Mailing Address - Street 2:#302B
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33125
Mailing Address - Country:US
Mailing Address - Phone:305-325-8771
Mailing Address - Fax:305-325-8770
Practice Address - Street 1:1399 NW 17 AVE
Practice Address - Street 2:#302B
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125
Practice Address - Country:US
Practice Address - Phone:305-325-8771
Practice Address - Fax:305-325-8770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies