Provider Demographics
NPI:1891983904
Name:NATIONWIDE DME LLC
Entity Type:Organization
Organization Name:NATIONWIDE DME LLC
Other - Org Name:NATIONWIDE DME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:LEVY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-893-8117
Mailing Address - Street 1:10800 BISCAYNE BLVD
Mailing Address - Street 2:STE 310
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33161-7482
Mailing Address - Country:US
Mailing Address - Phone:305-893-8117
Mailing Address - Fax:
Practice Address - Street 1:10800 BISCAYNE BLVD
Practice Address - Street 2:STE 310
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33161-7482
Practice Address - Country:US
Practice Address - Phone:305-893-8117
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-15
Last Update Date:2012-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL004151900Medicaid
FL6043660001Medicare NSC