Provider Demographics
NPI:1922612829
Name:DIRECT SHIELD MEDICAL SUPPLIES INC
Entity Type:Organization
Organization Name:DIRECT SHIELD MEDICAL SUPPLIES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHELO
Authorized Official - Middle Name:
Authorized Official - Last Name:ST. ELOI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-517-5994
Mailing Address - Street 1:4701 N FEDERAL HWY STE 455
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33064-6562
Mailing Address - Country:US
Mailing Address - Phone:800-517-5994
Mailing Address - Fax:954-715-5009
Practice Address - Street 1:4701 N FEDERAL HWY STE 455
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33064-6562
Practice Address - Country:US
Practice Address - Phone:800-517-5994
Practice Address - Fax:954-715-5009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-08
Last Update Date:2021-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies