Provider Demographics
NPI:1538105085
Name:CITY MEDICAL SUPPLY, INC.
Entity Type:Organization
Organization Name:CITY MEDICAL SUPPLY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ALFREDO
Authorized Official - Middle Name:VILLAVERDE
Authorized Official - Last Name:ZAYAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-260-9177
Mailing Address - Street 1:1901 NW 7TH ST
Mailing Address - Street 2:SUITE 107
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33125-3410
Mailing Address - Country:US
Mailing Address - Phone:305-260-9177
Mailing Address - Fax:305-260-9872
Practice Address - Street 1:1901 NW 7TH ST
Practice Address - Street 2:SUITE 107
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-3410
Practice Address - Country:US
Practice Address - Phone:305-260-9177
Practice Address - Fax:305-260-9872
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies