MEDICARE: AUSTIN 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	332BX2000X	Oxygen Equipment & Supplies (DME)	321289	FL
2	332B00000X	Durable Medical Equipment & Medical Supplies	715	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	:	1861484958
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AUSTIN MEDICAL SUPPLY INC

Provider Business Mailing Address
First Line	:	5327 NW 36TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33142-3205
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5327 NW 36TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33142-3205
Country	:	US
Telephone Number	:	306-638-7996
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MARTHA REYES
Credential	:
Telephone Number	:	305-638-7996

Provider Enumeration Date	:	08/16/2005
Last Update Date	:	04/04/2011

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Directions to “AUSTIN MEDICAL SUPPLY INC ” Practice Location

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