Provider Demographics
NPI:1750914826
Name:MEDICAL EQUIPMENT AND SUPPLIES OF AMERICA LLC
Entity type:Organization
Organization Name:MEDICAL EQUIPMENT AND SUPPLIES OF AMERICA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:ERIC
Authorized Official - Last Name:GELLERSTEDT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-851-9880
Mailing Address - Street 1:8767 MERRIMOOR BLVD STE 1
Mailing Address - Street 2:
Mailing Address - City:SEMINOLE
Mailing Address - State:FL
Mailing Address - Zip Code:33777-3133
Mailing Address - Country:US
Mailing Address - Phone:727-265-7556
Mailing Address - Fax:866-727-2399
Practice Address - Street 1:6848 HOFFNER AVE UNIT 4
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32822-3582
Practice Address - Country:US
Practice Address - Phone:727-265-7556
Practice Address - Fax:866-727-2399
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-18
Last Update Date:2020-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies