Provider Demographics
NPI:1780699108
Name:RAINBOW MEDICAL SUPPLIES, INC
Entity type:Organization
Organization Name:RAINBOW MEDICAL SUPPLIES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ERNESTO
Authorized Official - Middle Name:
Authorized Official - Last Name:REYNA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-419-5722
Mailing Address - Street 1:3600 S STATE ROAD 7
Mailing Address - Street 2:SUITE 307
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33023-5200
Mailing Address - Country:US
Mailing Address - Phone:954-964-2644
Mailing Address - Fax:954-964-2606
Practice Address - Street 1:3600 S STATE ROAD 7
Practice Address - Street 2:SUITE 307
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33023-5200
Practice Address - Country:US
Practice Address - Phone:954-964-2644
Practice Address - Fax:954-964-2606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL5482920001Medicare NSC