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General NPI Number Information
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NPI Number | 1437649951
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Entity Type | Organization
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Legal Business Name | CARDINAL CARE MEDICAL SUPPLY INC
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Dates
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Enumeration Date | 05/10/2018
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Last Update Date | 07/24/2020
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Provider Practice Location Address
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Address Line | 601 N CONGRESS AVE STE 110B
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City | DELRAY BEACH
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State | FL
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Zip | 33445
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Country | US
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Telephone | 561-330-4396
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Fax | 321-622-0165
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Provider Business Mailing Address
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Address Line | 601 N CONGRESS AVE STE 110B
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City | DELRAY BEACH
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State | FL
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Zip | 33445-4626
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Country | US
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Telephone | 561-330-4396
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | EASTON SUCHARSKI
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Credential |
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Telephone | 561-330-4396
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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