Healthcare Provider Details

I. General information

NPI: 1154643195
Provider Name (Legal Business Name): ROYAL PALM MEDICAL SUPPLY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/18/2010
Last Update Date: 02/09/2023
Certification Date: 12/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

941 S MILITARY TRL STE F9
WEST PALM BEACH FL
33415-3980
US

IV. Provider business mailing address

941 S MILITARY TRL # F9
WEST PALM BEACH FL
33415-3980
US

V. Phone/Fax

Practice location:
  • Phone: 561-253-0453
  • Fax: 877-849-9990
Mailing address:
  • Phone: 561-253-0453
  • Fax: 954-541-8525

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberORF153
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License NumberORF153
License Number StateFL

VIII. Authorized Official

Name: MR. JOHN HARTSHORN
Title or Position: PRESIDENT/OWNER
Credential:
Phone: 774-306-1536