Provider Demographics
NPI:1184742736
Name:SCI MEDICAL SUPPLY INC.
Entity type:Organization
Organization Name:SCI MEDICAL SUPPLY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:V
Authorized Official - Last Name:SWAIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-357-2982
Mailing Address - Street 1:7780 NW 7TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33150-3262
Mailing Address - Country:US
Mailing Address - Phone:305-696-4130
Mailing Address - Fax:305-696-4199
Practice Address - Street 1:7780 NW 7TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33150-3262
Practice Address - Country:US
Practice Address - Phone:305-696-4130
Practice Address - Fax:305-696-4199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2011-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH252553336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
5702635OtherNCPDP PROVIDER IDENTIFICATION NUMBER