Provider Demographics
NPI:1790890911
Name:AMERICAN DISCOUNT DIAPER OUTLET
Entity Type:Organization
Organization Name:AMERICAN DISCOUNT DIAPER OUTLET
Other - Org Name:AMERICAN DISCOUNT DIAPER OUTLET
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALICIA
Authorized Official - Middle Name:AMPARO
Authorized Official - Last Name:FIERRO
Authorized Official - Suffix:
Authorized Official - Credentials:DME
Authorized Official - Phone:561-533-8707
Mailing Address - Street 1:398 N CONGRESS AVE
Mailing Address - Street 2:SUITE 106
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33426-3467
Mailing Address - Country:US
Mailing Address - Phone:561-533-8707
Mailing Address - Fax:561-533-8705
Practice Address - Street 1:398 N CONGRESS AVE
Practice Address - Street 2:SUITE 106
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426-3467
Practice Address - Country:US
Practice Address - Phone:561-533-8707
Practice Address - Fax:561-533-8705
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-20
Last Update Date:2016-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2340332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL4779220001Medicare NSC