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General NPI Number Information
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NPI Number | 1629537139
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Entity Type | Organization
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Legal Business Name | INTERNATIONAL MEDICAL SUPPLY, INC
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Dates
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Enumeration Date | 03/14/2019
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Last Update Date | 02/05/2026
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Provider Practice Location Address
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Address Line | 7415 NW 57TH ST
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City | LAUDERHILL
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State | FL
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Zip | 33319-2101
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Country | US
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Telephone | 954-760-9255
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Fax | 954-760-4741
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Provider Business Mailing Address
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Address Line | 10810 NW 138TH ST UNIT 2
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City | HIALEAH GARDENS
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State | FL
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Zip | 33018-1107
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Country | US
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Telephone | 954-760-9255
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Fax | 954-760-4741
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Authorized Official
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Title or Position | MANAGER
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Name | MRS. YUDIT YCASA
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Credential |
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Telephone | 954-760-9255
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number |
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License Number State |
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