Provider Demographics
NPI:1679198576
Name:TRUST MED SUPPLY LLC
Entity Type:Organization
Organization Name:TRUST MED SUPPLY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:MANUEL
Authorized Official - Middle Name:ANTONIO
Authorized Official - Last Name:DELGADO PARRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-251-7796
Mailing Address - Street 1:1805 PONCE DE LEON BLVD APT 732
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-4462
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1805 PONCE DE LEON BLVD APT 732
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-4462
Practice Address - Country:US
Practice Address - Phone:786-251-7796
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-16
Last Update Date:2020-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies