Healthcare Provider Details

I. General information

NPI: 1619905205
Provider Name (Legal Business Name): ACCESS RESPIRATORY SUPPLY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3350 NW 22ND TER SUITE 100B
POMPANO BEACH FL
33069-1062
US

IV. Provider business mailing address

3350 NW 22ND TER SUITE 100B
POMPANO BEACH FL
33069-1062
US

V. Phone/Fax

Practice location:
  • Phone: 954-590-3770
  • Fax: 954-590-3771
Mailing address:
  • Phone: 954-590-3770
  • Fax: 954-590-3771

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPH22054
License Number StateFL

VIII. Authorized Official

Name: MR. DAVID A. WALLACE
Title or Position: PRESIDENT
Credential:
Phone: 954-590-3770