MEDICARE: MED SUPPLY US

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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1255981163
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MED SUPPLY US

Provider Business Mailing Address
First Line	:	1520 E SUNRISE BLVD STE 201
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33304-2363
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1520 E SUNRISE BLVD STE 201
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33304-2363
Country	:	US
Telephone Number	:	954-398-4474
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MR. GEORGE HERBERT COLONEY IV
Credential	:
Telephone Number	:	954-604-1000

Provider Enumeration Date	:	09/13/2019
Last Update Date	:	08/01/2022

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Directions to “MED SUPPLY US ” Practice Location

Language	Start Address	Practice Location

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