MEDICARE: STONE HEALTH MEDICAL SUPPLY 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

General Provider Information

NPI Number	:	1669083705
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STONE HEALTH MEDICAL SUPPLY LLC

Provider Business Mailing Address
First Line	:	2880 W OAKLAND PARK BLVD STE 107
Second Line	:
City	:	OAKLAND PARK
State	:	FL
Zip	:	33311-1362
Country	:	US
Telephone Number	:	954-368-6747
Fax Number	:

Provider Business Practice Location Address
First Line	:	2880 W OAKLAND PARK BLVD STE 107
Second Line	:
City	:	OAKLAND PARK
State	:	FL
Zip	:	33311-1362
Country	:	US
Telephone Number	:	954-368-6747
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ANDRE MITCHELL
Credential	:
Telephone Number	:	954-368-6747

Provider Enumeration Date	:	08/12/2020
Last Update Date	:	03/08/2021

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