Provider Demographics
NPI:1740400522
Name:M & M SUPPLY SERVICES GROUP, INC.
Entity Type:Organization
Organization Name:M & M SUPPLY SERVICES GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:
Authorized Official - Last Name:GUEVARA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-254-3050
Mailing Address - Street 1:13260 SW 131ST ST
Mailing Address - Street 2:SUITE 127
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-5871
Mailing Address - Country:US
Mailing Address - Phone:305-254-3050
Mailing Address - Fax:305-254-0170
Practice Address - Street 1:13260 SW 131ST ST
Practice Address - Street 2:SUITE 127
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-5871
Practice Address - Country:US
Practice Address - Phone:305-254-3050
Practice Address - Fax:305-254-0170
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-26
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL32 6536332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL5948740001Medicare NSC