MEDICARE: MEDICAL SUPPLIES COMPANY

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	Z3689	UT

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	:	1508913211
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDICAL SUPPLIES COMPANY

Provider Business Mailing Address
First Line	:	5443 CRESTHAVEN BLVD APT D
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33415-8073
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5443 CRESTHAVEN BLVD APT D
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33415-8073
Country	:	US
Telephone Number	:	201-953-4479
Fax Number	:

Authorized Official
Title or Position	:	PROPRETOR
Name	:	JOHN JOSEPH OWNES JR.
Credential	:
Telephone Number	:	201-953-4479

Provider Enumeration Date	:	01/04/2007
Last Update Date	:	08/22/2020

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Directions to “MEDICAL SUPPLIES COMPANY ” Practice Location

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