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NPI Code Detail

MEDICARE: OUTPATIENT MEDICAL SUPPLIES,LLC

MEDICARE: OUTPATIENT MEDICAL SUPPLIES,LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1332BX2000XOxygen Equipment & Supplies (DME)1313022FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11313022OTHERFLSTATE OF FL HME LICENCE

General Provider Information

NPI Number : 1295745222
Entity Type Code : Organization
Provider Name (Legal Business Name) : OUTPATIENT MEDICAL SUPPLIES,LLC
Provider Business Mailing Address
First Line : 7481 W OAKLAND PARK BLVD
Second Line : SUITE 303
City : TAMARAC
State : FL
Zip : 33319-4985
Country : US
Telephone Number : 954-572-2616
Fax Number : 954-572-6770
Provider Business Practice Location Address
First Line : 7481 W OAKLAND PARK BLVD
Second Line : SUITE 303
City : TAMARAC
State : FL
Zip : 33319-4985
Country : US
Telephone Number : 954-572-2616
Fax Number : 954-572-6770
Authorized Official
Title or Position : PRESIDENT/GENERAL MANAGER
Name : MR. MICHAEL OSWALD HONORE
Credential :
Telephone Number : 954-439-0142
Provider Enumeration Date : 08/09/2006
Last Update Date : 11/29/2007

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Directions to “OUTPATIENT MEDICAL SUPPLIES,LLC ” Practice Location

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