Provider Demographics
NPI:1952456071
Name:MILA MEDICAL SUPPLIES, INC.
Entity Type:Organization
Organization Name:MILA MEDICAL SUPPLIES, INC.
Other - Org Name:MILA MEDICAL SUPPLIES & FARMACY, INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LIUDMILA
Authorized Official - Middle Name:
Authorized Official - Last Name:RUIZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-819-9175
Mailing Address - Street 1:1646 W 38TH PL
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-7026
Mailing Address - Country:US
Mailing Address - Phone:305-819-9175
Mailing Address - Fax:305-819-9177
Practice Address - Street 1:1646 W 38TH PL
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-7026
Practice Address - Country:US
Practice Address - Phone:305-819-9175
Practice Address - Fax:305-819-9177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2007-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1312095332B00000X
FLPH22804333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPH 22804OtherPHARMACY
FL32-03682OtherOXYGEN LICENSE
FL1312095OtherHME STATE LICENSE
FL32-03682OtherOXYGEN LICENSE