Provider Demographics
NPI:1922150440
Name:ACO MEDICAL SUPPLY
Entity Type:Organization
Organization Name:ACO MEDICAL SUPPLY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SANTOS
Authorized Official - Middle Name:
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-468-9338
Mailing Address - Street 1:1414 NW 107TH AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33172-2732
Mailing Address - Country:US
Mailing Address - Phone:305-468-9338
Mailing Address - Fax:
Practice Address - Street 1:1414 NW 107TH AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33172-2732
Practice Address - Country:US
Practice Address - Phone:305-468-9338
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies