Provider Demographics
NPI:1528386109
Name:UROLOGICAL SUPPLIES, INC.
Entity Type:Organization
Organization Name:UROLOGICAL SUPPLIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:P
Authorized Official - Last Name:STAFFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-985-9327
Mailing Address - Street 1:PO BOX 301
Mailing Address - Street 2:
Mailing Address - City:ESTERO
Mailing Address - State:FL
Mailing Address - Zip Code:33929-0301
Mailing Address - Country:US
Mailing Address - Phone:239-985-9327
Mailing Address - Fax:239-985-9614
Practice Address - Street 1:9841 BERNWOOD PLACE DR
Practice Address - Street 2:SUITE 130
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33966-6516
Practice Address - Country:US
Practice Address - Phone:239-985-9327
Practice Address - Fax:239-985-9614
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-06
Last Update Date:2014-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies