Provider Demographics
NPI:1679189815
Name:PRO-MED EQUIPMENT LLC
Entity Type:Organization
Organization Name:PRO-MED EQUIPMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PHIL
Authorized Official - Middle Name:
Authorized Official - Last Name:MONTANO
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:772-324-8914
Mailing Address - Street 1:1320 SE FEDERAL HWY STE 213
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-3410
Mailing Address - Country:US
Mailing Address - Phone:772-324-8914
Mailing Address - Fax:
Practice Address - Street 1:1320 SE FEDERAL HWY STE 213
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-3410
Practice Address - Country:US
Practice Address - Phone:772-324-8914
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-22
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies