Provider Demographics
NPI:1922750694
Name:OMNIMED SUPPLIES CORP.
Entity Type:Organization
Organization Name:OMNIMED SUPPLIES CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:ELRIFY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-399-6350
Mailing Address - Street 1:10211 W SAMPLE RD STE 206
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-3991
Mailing Address - Country:US
Mailing Address - Phone:813-399-6350
Mailing Address - Fax:
Practice Address - Street 1:10211 W SAMPLE RD STE 206
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-3991
Practice Address - Country:US
Practice Address - Phone:754-336-1231
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-24
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies