Provider Demographics
NPI:1730669136
Name:OG MEDICAL SUPPLIES
Entity Type:Organization
Organization Name:OG MEDICAL SUPPLIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:OSCAR
Authorized Official - Middle Name:
Authorized Official - Last Name:GAREA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-300-1564
Mailing Address - Street 1:1001 E SAMPLE RD STE 5E
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33064-5147
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1001 E SAMPLE RD STE 5E
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33064-5147
Practice Address - Country:US
Practice Address - Phone:954-933-3653
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-15
Last Update Date:2018-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies