MEDICARE: OMEGA MEDICAL SUPPLY, CORP

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	:	1831311281
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OMEGA MEDICAL SUPPLY, CORP

Provider Business Mailing Address
First Line	:	1516 E 4TH AVE
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33010-3159
Country	:	US
Telephone Number	:	305-887-6263
Fax Number	:	305-887-6264

Provider Business Practice Location Address
First Line	:	1516 E 4TH AVE
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33010-3159
Country	:	US
Telephone Number	:	305-887-6263
Fax Number	:	305-887-6264

Authorized Official
Title or Position	:	PRESIDENT
Name	:	HECTOR R ODUARDO
Credential	:
Telephone Number	:	305-887-6263

Provider Enumeration Date	:	05/03/2007
Last Update Date	:	08/22/2020

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