Provider Demographics
NPI:1700889227
Name:UNITED STATES MEDICAL SUPPLY, LLC
Entity Type:Organization
Organization Name:UNITED STATES MEDICAL SUPPLY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:CLYDALL
Authorized Official - Middle Name:
Authorized Official - Last Name:BOBB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-787-6331
Mailing Address - Street 1:8200 NW 33RD ST STE 200
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33122-1942
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8200 NW 33RD ST STE 200
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33122-1942
Practice Address - Country:US
Practice Address - Phone:305-436-6033
Practice Address - Fax:305-436-1137
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:US MED ACQUISITION, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-05-30
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1129690001Medicare NSC