Provider Demographics
NPI:1831505007
Name:SCOTTS MEDICAL SUPPLY INC.
Entity type:Organization
Organization Name:SCOTTS MEDICAL SUPPLY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:GISELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHARLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-304-7030
Mailing Address - Street 1:PO BOX 1484
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33429-1484
Mailing Address - Country:US
Mailing Address - Phone:800-304-7030
Mailing Address - Fax:800-594-1226
Practice Address - Street 1:1746 COSTA DEL SOL
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33432-1747
Practice Address - Country:US
Practice Address - Phone:800-304-7030
Practice Address - Fax:800-594-1226
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-08
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2015082322332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies