Provider Demographics
NPI:1477046084
Name:US MED, LLC
Entity Type:Organization
Organization Name:US MED, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:CLYDALL
Authorized Official - Middle Name:
Authorized Official - Last Name:BOBB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-787-6331
Mailing Address - Street 1:8491 NW 17TH ST STE #102
Mailing Address - Street 2:ATTN LICENSING
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8491 NW 17TH ST STE #102
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126
Practice Address - Country:US
Practice Address - Phone:866-938-4482
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:US MED ACQUISITION, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-06-08
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH235213336M0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336M0002XSuppliersPharmacyMail Order Pharmacy