Provider Demographics
NPI:1467741017
Name:CMC HEALTH CARE SUPPLIERS, LLC.
Entity Type:Organization
Organization Name:CMC HEALTH CARE SUPPLIERS, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/GENERAL MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ADRIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:ANZOLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-639-2140
Mailing Address - Street 1:8390 NW 53RD ST
Mailing Address - Street 2:SUITE 114
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33166-7813
Mailing Address - Country:US
Mailing Address - Phone:305-639-2140
Mailing Address - Fax:305-639-2141
Practice Address - Street 1:8390 NW 53RD ST
Practice Address - Street 2:SUITE 114
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33166-7813
Practice Address - Country:US
Practice Address - Phone:305-639-2140
Practice Address - Fax:305-639-2141
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-05
Last Update Date:2011-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies