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General NPI Number Information
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NPI Number | 1801409727
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Entity Type | Organization
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Legal Business Name | NATIONAL SUPPLY GROUP LLC
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Dates
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Enumeration Date | 08/29/2020
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Last Update Date | 10/26/2020
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Provider Practice Location Address
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Address Line | 4401 N DIXIE HWY
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City | BOCA RATON
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State | FL
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Zip | 33431-5028
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Country | US
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Telephone | 347-441-8559
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Fax |
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Provider Business Mailing Address
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Address Line | 4401 N DIXIE HWY
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City | BOCA RATON
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State | FL
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Zip | 33431-5028
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Country | US
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Telephone | 800-496-3534
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Fax |
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Authorized Official
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Title or Position | MEMBER MANAGER
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Name | MICHAEL HENDERSON
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Credential |
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Telephone | 347-441-8559
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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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