Provider Demographics
NPI:1689918997
Name:A & C MEDICAL SUPPLIES INC
Entity Type:Organization
Organization Name:A & C MEDICAL SUPPLIES INC
Other - Org Name:PHARMACHOICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MISLEIDYS
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-223-0090
Mailing Address - Street 1:3955 SW 137TH AVE
Mailing Address - Street 2:STE D5
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-6478
Mailing Address - Country:US
Mailing Address - Phone:305-223-0090
Mailing Address - Fax:305-223-0091
Practice Address - Street 1:3955 SW 137TH AVE
Practice Address - Street 2:STE D5
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-6478
Practice Address - Country:US
Practice Address - Phone:305-223-0090
Practice Address - Fax:305-223-0091
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-27
Last Update Date:2013-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH255663336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
5712434OtherNCPDP PROVIDER IDENTIFICATION NUMBER