MEDICARE: SCOTTS MEDICAL SUPPLY 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	2015082322	FL

General Provider Information

NPI Number	:	1831505007
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SCOTTS MEDICAL SUPPLY INC.

Provider Business Mailing Address
First Line	:	PO BOX 1484
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33429-1484
Country	:	US
Telephone Number	:	800-304-7030
Fax Number	:	800-594-1226

Provider Business Practice Location Address
First Line	:	1746 COSTA DEL SOL
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33432-1747
Country	:	US
Telephone Number	:	800-304-7030
Fax Number	:	800-594-1226

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MS. GISELLE CHARLES
Credential	:
Telephone Number	:	800-304-7030

Provider Enumeration Date	:	07/08/2014
Last Update Date	:	06/02/2021

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