Provider Demographics
NPI:1609153279
Name:NATIONAL MED SUPPLY LLC
Entity Type:Organization
Organization Name:NATIONAL MED SUPPLY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MISS
Authorized Official - First Name:SANDI
Authorized Official - Middle Name:
Authorized Official - Last Name:KEMRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-777-1033
Mailing Address - Street 1:5000 S CRESCENT DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33611-4120
Mailing Address - Country:US
Mailing Address - Phone:813-777-1033
Mailing Address - Fax:
Practice Address - Street 1:5000 S CRESCENT DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33611-4120
Practice Address - Country:US
Practice Address - Phone:813-777-1033
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-10
Last Update Date:2011-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLL09000089297332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLL09000089297OtherSTATE