Provider Demographics
NPI:1609829993
Name:MEDICAL HEALTH CARE SUPPLY
Entity Type:Organization
Organization Name:MEDICAL HEALTH CARE SUPPLY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CESAR
Authorized Official - Middle Name:A
Authorized Official - Last Name:DISCUA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-512-1304
Mailing Address - Street 1:1490 W 49 PL
Mailing Address - Street 2:SUITE 598
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012
Mailing Address - Country:US
Mailing Address - Phone:305-512-1304
Mailing Address - Fax:305-512-1305
Practice Address - Street 1:1490 W 49 PL
Practice Address - Street 2:SUITE 598
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012
Practice Address - Country:US
Practice Address - Phone:305-512-1304
Practice Address - Fax:305-512-1304
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
5539780001Medicare ID - Type Unspecified