MEDICARE: IROCK MED 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
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1760312953
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IROCK MED SUPPLIES LLC

Provider Business Mailing Address
First Line	:	1014 N 1300 W
Second Line	:
City	:	PLEASANT GROVE
State	:	UT
Zip	:	84062-9463
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1014 N 1300 W
Second Line	:
City	:	PLEASANT GROVE
State	:	UT
Zip	:	84062-9463
Country	:	US
Telephone Number	:	914-577-1352
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	IZAK ROCK
Credential	:
Telephone Number	:	914-577-1352

Provider Enumeration Date	:	05/20/2026
Last Update Date	:	05/20/2026

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