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General NPI Number Information
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NPI Number | 1508045105
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Entity Type | Organization
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Legal Business Name | S & T MEDICAL SUPPLY INC.
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Dates
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Enumeration Date | 10/31/2007
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Last Update Date | 05/05/2023
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Provider Practice Location Address
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Address Line | 11054 S MILITARY TRL
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City | BOYNTON BEACH
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State | FL
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Zip | 33436-7217
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Country | US
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Telephone | 561-364-2600
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Fax | 561-364-2199
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Provider Business Mailing Address
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Address Line | 11054 S MILITARY TRL
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City | BOYNTON BEACH
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State | FL
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Zip | 33436-7217
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Country | US
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Telephone | 561-364-2600
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Fax | 561-364-2199
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MS. NATALIA PROHOROVA
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Credential |
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Telephone | 561-364-2600
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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 | 1644
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License Number State | FL
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