Provider Demographics
NPI:1518578293
Name:CMO MEDICAL SUPPLY COMPANY LLC
Entity Type:Organization
Organization Name:CMO MEDICAL SUPPLY COMPANY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CONNOR
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-339-3088
Mailing Address - Street 1:1080 E INDIANTOWN RD STE 103A
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33477-5188
Mailing Address - Country:US
Mailing Address - Phone:561-339-3088
Mailing Address - Fax:
Practice Address - Street 1:1080 E INDIANTOWN RD STE 103A
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33477-5188
Practice Address - Country:US
Practice Address - Phone:561-339-3088
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-14
Last Update Date:2021-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies