Provider Demographics
NPI:1740216308
Name:DISNEY MEDICAL EQUIPMENT INC
Entity Type:Organization
Organization Name:DISNEY MEDICAL EQUIPMENT INC
Other - Org Name:DISNEY PHARMACY DISCOUNT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:SARA
Authorized Official - Middle Name:
Authorized Official - Last Name:PADRON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-688-9911
Mailing Address - Street 1:4849 E 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33013-2046
Mailing Address - Country:US
Mailing Address - Phone:305-688-9911
Mailing Address - Fax:305-688-9977
Practice Address - Street 1:4849 E 8TH AVE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33013-2046
Practice Address - Country:US
Practice Address - Phone:305-688-9911
Practice Address - Fax:305-688-9977
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH151653336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1052310002Medicare NSC