Provider Demographics
NPI:1841804119
Name:TIMES MEDICAL SUPPLY CORP
Entity Type:Organization
Organization Name:TIMES MEDICAL SUPPLY CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANDRES
Authorized Official - Middle Name:
Authorized Official - Last Name:ACOSTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-747-4961
Mailing Address - Street 1:455 W 23RD ST UNIT 8
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33010-1415
Mailing Address - Country:US
Mailing Address - Phone:786-747-4961
Mailing Address - Fax:
Practice Address - Street 1:455 W 23RD ST UNIT 8
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33010-1415
Practice Address - Country:US
Practice Address - Phone:786-747-4961
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-03
Last Update Date:2020-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies