Provider Demographics
NPI:1700023553
Name:EROS SUPPLIES & SERVICES INC
Entity Type:Organization
Organization Name:EROS SUPPLIES & SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EMILIO
Authorized Official - Middle Name:DE JESUS
Authorized Official - Last Name:MONDELO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-234-0901
Mailing Address - Street 1:14171 SW 142ND AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-6795
Mailing Address - Country:US
Mailing Address - Phone:305-234-0901
Mailing Address - Fax:
Practice Address - Street 1:14171 SW 142ND AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-6795
Practice Address - Country:US
Practice Address - Phone:305-234-0901
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-15
Last Update Date:2009-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PENDING MEDICARE#OtherPENDING MEDICARE #