MEDICARE: DURAMED 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	:	1770105124
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DURAMED SUPPLY LLC

Provider Business Mailing Address
First Line	:	16100 NE 16TH AVE STE B
Second Line	:
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33162-4708
Country	:	US
Telephone Number	:	305-949-5999
Fax Number	:

Provider Business Practice Location Address
First Line	:	16100 NE 16TH AVE STE B
Second Line	:
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33162-4708
Country	:	US
Telephone Number	:	305-949-5999
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. MARC WEINBERG
Credential	:	DC
Telephone Number	:	305-949-5999

Provider Enumeration Date	:	05/08/2020
Last Update Date	:	05/08/2020

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