MEDICARE: INTERNATIONAL MEDICAL EQUIPMENT USA LLC

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
2	332BX2000X	Oxygen Equipment & Supplies (DME)

General Provider Information

NPI Number	:	1336829308
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTERNATIONAL MEDICAL EQUIPMENT USA LLC

Provider Business Mailing Address
First Line	:	501 GOLDEN ISLES DR STE 204F
Second Line	:
City	:	HALLANDALE BEACH
State	:	FL
Zip	:	33009-4729
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	501 GOLDEN ISLES DR STE 204F
Second Line	:
City	:	HALLANDALE BEACH
State	:	FL
Zip	:	33009-4729
Country	:	US
Telephone Number	:	347-630-2468
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	MR. ANGELLEN AGUVAYEV
Credential	:
Telephone Number	:	347-630-2468

Provider Enumeration Date	:	07/24/2023
Last Update Date	:	07/24/2023

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