Provider Demographics
NPI:1780731190
Name:FAMILY HEALTHCARE SUPPLY INC
Entity type:Organization
Organization Name:FAMILY HEALTHCARE SUPPLY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:GAIL
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:BIZUB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-923-7556
Mailing Address - Street 1:3672 WEBBER ST
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34232-4413
Mailing Address - Country:US
Mailing Address - Phone:941-923-7556
Mailing Address - Fax:941-927-2104
Practice Address - Street 1:3672 WEBBER ST
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34232-4413
Practice Address - Country:US
Practice Address - Phone:941-923-7556
Practice Address - Fax:941-927-2104
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-05
Last Update Date:2007-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL14332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0133670001Medicare ID - Type Unspecified