Provider Demographics
NPI:1245893064
Name:SMART MEDICAL SUPPLY LLC
Entity type:Organization
Organization Name:SMART MEDICAL SUPPLY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEMBER MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:LOIZZO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:754-332-2889
Mailing Address - Street 1:1975 E. SUNRISE BLVD
Mailing Address - Street 2:STE 802
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33304
Mailing Address - Country:US
Mailing Address - Phone:754-332-2889
Mailing Address - Fax:
Practice Address - Street 1:1975 E SUNRISE BLVD
Practice Address - Street 2:STE 802
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33304
Practice Address - Country:US
Practice Address - Phone:754-332-2889
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-17
Last Update Date:2020-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies