Healthcare Provider Details

I. General information

NPI: 1417267634
Provider Name (Legal Business Name): FIRST QUALITY MEDICAL SUPPLIES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2010
Last Update Date: 01/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7262 SW 48TH ST
MIAMI FL
33155-5525
US

IV. Provider business mailing address

7262 SW 48TH ST
MIAMI FL
33155-5525
US

V. Phone/Fax

Practice location:
  • Phone: 305-262-7005
  • Fax:
Mailing address:
  • Phone: 305-262-7005
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number1312136
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number1312136
License Number StateFL

VIII. Authorized Official

Name: SUSANA ROSA WEDDLE
Title or Position: PRESIDENT
Credential:
Phone: 305-262-7005