Healthcare Provider Details

I. General information

NPI: 1124136247
Provider Name (Legal Business Name): EASTERN MEDICAL EQUIPMENT DISTRIBUTORS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1324 S FEDERAL HWY
POMPANO BEACH FL
33062-7232
US

IV. Provider business mailing address

1324 S FEDERAL HWY
POMPANO BEACH FL
33062-7232
US

V. Phone/Fax

Practice location:
  • Phone: 954-788-8009
  • Fax: 954-788-8007
Mailing address:
  • Phone: 954-788-8009
  • Fax: 954-788-8007

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number1260
License Number StateFL

VIII. Authorized Official

Name: MR. RONALD VINCENT ANNECHIARICO SR.
Title or Position: PRESIDENT
Credential: R.N.
Phone: 954-788-8009