Healthcare Provider Details

I. General information

NPI: 1811067184
Provider Name (Legal Business Name): MEDICAL SUPPLY USA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2006
Last Update Date: 02/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1940 NORTHGATE BLVD UNIT B-5
SARASOTA FL
34234-2162
US

IV. Provider business mailing address

1940 NORTHGATE BLVD UNIT B-5
SARASOTA FL
34234-2162
US

V. Phone/Fax

Practice location:
  • Phone: 941-358-0099
  • Fax: 941-358-0091
Mailing address:
  • Phone: 941-358-0099
  • Fax: 941-358-0091

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number1313204
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number326458
License Number StateFL

VIII. Authorized Official

Name: TERESA OCHOA
Title or Position: PRESIDENT
Credential:
Phone: 941-358-0099