Healthcare Provider Details

I. General information

NPI: 1255981163
Provider Name (Legal Business Name): MED SUPPLY US
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2019
Last Update Date: 07/03/2026
Certification Date: 07/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 OAKWOOD BLVD STE 212
HOLLYWOOD FL
33020-1954
US

IV. Provider business mailing address

1 OAKWOOD BLVD STE 212
HOLLYWOOD FL
33020-1954
US

V. Phone/Fax

Practice location:
  • Phone: 954-398-4474
  • Fax:
Mailing address:
  • Phone: 954-398-4474
  • Fax: 954-530-4000

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MR. GEORGE HERBERT COLONEY IV
Title or Position: OWNER
Credential:
Phone: 954-398-4474