MEDICARE: ONE STOP MEDICAL SUPPLIES, 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	332BX2000X	Oxygen Equipment & Supplies (DME)	32:02499	FL
2	332BX2000X	Oxygen Equipment & Supplies (DME)	1071	FL

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	:	1760403851
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ONE STOP MEDICAL SUPPLIES, INC

Provider Business Mailing Address
First Line	:	3773 NE 163RD ST
Second Line	:
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33160-4104
Country	:	US
Telephone Number	:	305-947-8960
Fax Number	:	305-947-8322

Provider Business Practice Location Address
First Line	:	3773 NE 163RD ST
Second Line	:
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33160-4104
Country	:	US
Telephone Number	:	305-947-8960
Fax Number	:	305-947-8322

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ALLA A PRUZHININ
Credential	:
Telephone Number	:	305-947-8960

Provider Enumeration Date	:	07/22/2006
Last Update Date	:	02/24/2010

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Directions to “ONE STOP MEDICAL SUPPLIES, INC ” Practice Location

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