MEDICARE: RIS DURABLE MEDICAL EQUIPMENT 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	332BC3200X	Customized Equipment (DME)

General Provider Information

NPI Number	:	1417736539
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RIS DURABLE MEDICAL EQUIPMENT INC

Provider Business Mailing Address
First Line	:	2315 S DIXIE HWY
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33401-7913
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2315 S DIXIE HWY
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33401-7913
Country	:	US
Telephone Number	:	305-240-9652
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	REGINA TABAKOV
Credential	:
Telephone Number	:	305-240-9652

Provider Enumeration Date	:	09/27/2023
Last Update Date	:	09/27/2023

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