Healthcare Provider Details

I. General information

NPI: 1568595320
Provider Name (Legal Business Name): NEW HOPE MEDICAL SUPPLIES CO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2007
Last Update Date: 11/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12471 SW 130TH ST SUITE B-19
MIAMI FL
33186-6236
US

IV. Provider business mailing address

12471 SW 130TH ST SUITE B-19
MIAMI FL
33186-6236
US

V. Phone/Fax

Practice location:
  • Phone: 305-278-4428
  • Fax: 305-278-4429
Mailing address:
  • Phone: 305-278-4428
  • Fax: 305-278-4429

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number1313335
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number326555
License Number StateFL

VIII. Authorized Official

Name: ANNIA I. JUNCO
Title or Position: PRESIDENT
Credential:
Phone: 305-278-4428