Provider Demographics
NPI:1134173529
Name:QUANTUM MEDICAL SUPPLY, INC.
Entity type:Organization
Organization Name:QUANTUM MEDICAL SUPPLY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:JASON
Authorized Official - Last Name:VETRANO
Authorized Official - Suffix:
Authorized Official - Credentials:CPED
Authorized Official - Phone:561-432-8200
Mailing Address - Street 1:1818 S AUSTRALIAN AVE STE 301&304
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-6452
Mailing Address - Country:US
Mailing Address - Phone:561-432-8200
Mailing Address - Fax:561-432-8205
Practice Address - Street 1:1818 S AUSTRALIAN AVE STE 301&304
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409-6452
Practice Address - Country:US
Practice Address - Phone:561-432-8200
Practice Address - Fax:561-432-8205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-20
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL4828870001Medicare NSC