Provider Demographics
NPI:1609419795
Name:MILFORD MEDICAL SUPPLIES, INC
Entity Type:Organization
Organization Name:MILFORD MEDICAL SUPPLIES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:NEIL
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-685-3859
Mailing Address - Street 1:360 CENTRAL AVE STE 848
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-3857
Mailing Address - Country:US
Mailing Address - Phone:727-501-4947
Mailing Address - Fax:
Practice Address - Street 1:360 CENTRAL AVE STE 848
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-3857
Practice Address - Country:US
Practice Address - Phone:727-501-4947
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MILFORD MEDICAL SUPPLIES, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-10-22
Last Update Date:2019-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies