MEDICARE: SUNCOAST MEDICARE SUPPLY CO. INC.

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
1	332B00000X	Durable Medical Equipment & Medical Supplies	212	FL

General Provider Information

NPI Number	:	1548226137
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUNCOAST MEDICARE SUPPLY CO. INC.

Provider Business Mailing Address
First Line	:	1145 53RD AVE W
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34207-2858
Country	:	US
Telephone Number	:	941-758-7768
Fax Number	:	941-758-9881

Provider Business Practice Location Address
First Line	:	1145 53RD AVE W
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34207-2858
Country	:	US
Telephone Number	:	941-758-7768
Fax Number	:	941-758-9881

Authorized Official
Title or Position	:	PRESIDENT/CFO
Name	:	MR. BARRY E BALDWIN
Credential	:
Telephone Number	:	727-821-7015

Provider Enumeration Date	:	04/24/2006
Last Update Date	:	08/21/2019

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