Provider Demographics
NPI:1881039790
Name:UNITED STATES MEDICAL SUPPLY, LLC
Entity Type:Organization
Organization Name:UNITED STATES MEDICAL SUPPLY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:CLYDALL
Authorized Official - Middle Name:
Authorized Official - Last Name:BOBB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-787-6331
Mailing Address - Street 1:8260 NW 27TH ST STE 403
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33122-1903
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:100 W BIG BEAVER RD STE 200-42
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48084-5206
Practice Address - Country:US
Practice Address - Phone:305-436-6033
Practice Address - Fax:305-436-1137
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:US MED ACQUISITION, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-05-06
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIL2239773332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies