Provider Demographics
NPI:1609367937
Name:S B TRUST LLC
Entity Type:Organization
Organization Name:S B TRUST LLC
Other - Org Name:PALM BEACH MEDICAL SUPPLY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BROCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-877-6894
Mailing Address - Street 1:2755 S FEDERAL HWY STE 5
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33435-7742
Mailing Address - Country:US
Mailing Address - Phone:561-877-6894
Mailing Address - Fax:561-432-7900
Practice Address - Street 1:2755 S FEDERAL HWY STE 5
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33435-7742
Practice Address - Country:US
Practice Address - Phone:561-877-6894
Practice Address - Fax:561-423-7900
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:S B TRUST LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-05-22
Last Update Date:2019-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies