Provider Demographics
NPI:1245319045
Name:B & O MEDICAL EQUIPMENT SUPPLY, INC
Entity type:Organization
Organization Name:B & O MEDICAL EQUIPMENT SUPPLY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BERKIS
Authorized Official - Middle Name:
Authorized Official - Last Name:OLIVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-461-9348
Mailing Address - Street 1:1000 PONCE DE LEON BLVD
Mailing Address - Street 2:SUITE 115
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-3353
Mailing Address - Country:US
Mailing Address - Phone:305-461-9348
Mailing Address - Fax:
Practice Address - Street 1:1000 PONCE DE LEON BLVD
Practice Address - Street 2:SUITE 115
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-3353
Practice Address - Country:US
Practice Address - Phone:305-461-9348
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-03
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL5936730001Medicare NSC