Healthcare Provider Details

I. General information

NPI: 1023041803
Provider Name (Legal Business Name): BI COUNTY MEDICAL SUPPLY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2006
Last Update Date: 09/21/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1662 NW 36TH ST
MIAMI FL
33142-5572
US

IV. Provider business mailing address

1662 NW 36TH ST
MIAMI FL
33142-5572
US

V. Phone/Fax

Practice location:
  • Phone: 305-637-0666
  • Fax: 305-637-0740
Mailing address:
  • Phone: 305-637-0666
  • Fax: 305-637-0740

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberPH21453
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPH21453
License Number StateFL

VIII. Authorized Official

Name: CARLOS DIAZ-BATTE
Title or Position: OWNER PRESIDENT
Credential:
Phone: 305-637-0666