Provider Demographics
NPI:1659091668
Name:UNIVERSAL ALL MEDICAL SUPPLY
Entity Type:Organization
Organization Name:UNIVERSAL ALL MEDICAL SUPPLY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:UNIVERSAL
Authorized Official - Middle Name:
Authorized Official - Last Name:ALL MEDICAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-504-0517
Mailing Address - Street 1:105 GRAND CLUB PL
Mailing Address - Street 2:
Mailing Address - City:FORT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34982-8123
Mailing Address - Country:US
Mailing Address - Phone:800-504-0517
Mailing Address - Fax:863-812-4818
Practice Address - Street 1:105 GRAND CLUB PL
Practice Address - Street 2:
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34982-8123
Practice Address - Country:US
Practice Address - Phone:754-234-4839
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-30
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies