Provider Demographics
NPI:1558445874
Name:RICHARD MEDICAL SUPPLIES INC
Entity Type:Organization
Organization Name:RICHARD MEDICAL SUPPLIES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICARDO
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-863-0317
Mailing Address - Street 1:455 W 23RD STREET
Mailing Address - Street 2:STE 6
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33010
Mailing Address - Country:US
Mailing Address - Phone:305-863-0317
Mailing Address - Fax:305-863-0619
Practice Address - Street 1:455 W 23RD STREET
Practice Address - Street 2:STE 6
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33010
Practice Address - Country:US
Practice Address - Phone:305-863-0317
Practice Address - Fax:305-863-0619
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-24
Last Update Date:2008-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1313163332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL5919560001Medicare NSC