MEDICARE: CAMBRIDGE MEDICAL SUPPLY 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

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	:	1629040324
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAMBRIDGE MEDICAL SUPPLY INC

Provider Business Mailing Address
First Line	:	218 O'BRIEN HIGHWAY
Second Line	:
City	:	CAMBRIDGE
State	:	MA
Zip	:	02141
Country	:	US
Telephone Number	:	617-876-3810
Fax Number	:	617-864-8412

Provider Business Practice Location Address
First Line	:	799 CONCORD AVE
Second Line	:
City	:	CAMBRIDGE
State	:	MA
Zip	:	02138-1048
Country	:	US
Telephone Number	:	617-876-3810
Fax Number	:	617-864-8412

Authorized Official
Title or Position	:	CEO
Name	:	MR. TIMOTHY JAMES HOFFMAN
Credential	:
Telephone Number	:	617-876-3810

Provider Enumeration Date	:	02/06/2006
Last Update Date	:	01/17/2020

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