Provider Demographics
NPI:1821615071
Name:SOUTH SHORE MEDICAL SUPPLIES LLC
Entity Type:Organization
Organization Name:SOUTH SHORE MEDICAL SUPPLIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:GINSBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-486-9263
Mailing Address - Street 1:134 NW 16TH ST STE 2
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33432-1691
Mailing Address - Country:US
Mailing Address - Phone:516-790-3861
Mailing Address - Fax:
Practice Address - Street 1:1975 E SUNRISE BLVD STE 624
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33304-1453
Practice Address - Country:US
Practice Address - Phone:561-486-9263
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-02
Last Update Date:2020-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies