Provider Demographics
NPI:1295705507
Name:A1 MEDICAL SUPPLIES INC
Entity type:Organization
Organization Name:A1 MEDICAL SUPPLIES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BHARAT
Authorized Official - Middle Name:H
Authorized Official - Last Name:SEDANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-615-1819
Mailing Address - Street 1:11378 MANATEE BAY LN
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33449-8385
Mailing Address - Country:US
Mailing Address - Phone:561-615-1819
Mailing Address - Fax:561-423-9240
Practice Address - Street 1:7356 LAKE WORTH RD
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33467-2529
Practice Address - Country:US
Practice Address - Phone:561-615-1819
Practice Address - Fax:561-423-9240
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-26
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL032400100Medicaid
FLR-8919OtherBLUE CROSS BLUE SHIELD FL
FL032400100Medicaid