MEDICARE: EASTERN MEDICAL EQUIPMENT DISTRIBUTORS INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies	1260	FL

General Provider Information

NPI Number	:	1124136247
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EASTERN MEDICAL EQUIPMENT DISTRIBUTORS INC.

Provider Business Mailing Address
First Line	:	1324 S FEDERAL HWY
Second Line	:
City	:	POMPANO BEACH
State	:	FL
Zip	:	33062-7232
Country	:	US
Telephone Number	:	954-788-8009
Fax Number	:	954-788-8007

Provider Business Practice Location Address
First Line	:	1324 S FEDERAL HWY
Second Line	:
City	:	POMPANO BEACH
State	:	FL
Zip	:	33062-7232
Country	:	US
Telephone Number	:	954-788-8009
Fax Number	:	954-788-8007

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. RONALD VINCENT ANNECHIARICO SR.
Credential	:	R.N.
Telephone Number	:	954-788-8009

Provider Enumeration Date	:	08/28/2006
Last Update Date	:	08/22/2020

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