Provider Demographics
NPI:1740367234
Name:Y & D MEDICAL SUPPLY, INC.
Entity type:Organization
Organization Name:Y & D MEDICAL SUPPLY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:LAZARO
Authorized Official - Last Name:CASTELLON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-269-9539
Mailing Address - Street 1:7911 NW 72ND AVE STE 201A
Mailing Address - Street 2:
Mailing Address - City:MEDLEY
Mailing Address - State:FL
Mailing Address - Zip Code:33166-2223
Mailing Address - Country:US
Mailing Address - Phone:305-887-4702
Mailing Address - Fax:305-887-4710
Practice Address - Street 1:7911 NW 72ND AVE STE 201A
Practice Address - Street 2:
Practice Address - City:MEDLEY
Practice Address - State:FL
Practice Address - Zip Code:33166-2223
Practice Address - Country:US
Practice Address - Phone:305-887-4702
Practice Address - Fax:305-887-4710
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL5708260001Medicare NSC