Provider Demographics
NPI:1790898948
Name:WESTCHESTER MEDICAL SUPPLY, CORP.
Entity Type:Organization
Organization Name:WESTCHESTER MEDICAL SUPPLY, CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ALEXIS
Authorized Official - Middle Name:
Authorized Official - Last Name:CABALLERO-RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-275-5858
Mailing Address - Street 1:9745 SW 72ND ST
Mailing Address - Street 2:SUITE 116-A
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-4652
Mailing Address - Country:US
Mailing Address - Phone:305-275-5858
Mailing Address - Fax:305-270-6847
Practice Address - Street 1:9745 SW 72ND ST
Practice Address - Street 2:SUITE 116-A
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-4652
Practice Address - Country:US
Practice Address - Phone:305-275-5858
Practice Address - Fax:305-270-6847
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-15
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL5922000001Medicare NSC