MEDICARE: SN DME, 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	:	1881232742
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SN DME, LLC

Provider Business Mailing Address
First Line	:	3313 W COMMERCIAL BLVD STE 130
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33309-3413
Country	:	US
Telephone Number	:	800-748-2129
Fax Number	:

Provider Business Practice Location Address
First Line	:	3313 W COMMERCIAL BLVD STE 130
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33309-3413
Country	:	US
Telephone Number	:	800-748-2129
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR, CONTRACT ADMINISTRATION
Name	:	LOUIS MARTIN FISCHLER
Credential	:
Telephone Number	:	954-395-1533

Provider Enumeration Date	:	12/11/2019
Last Update Date	:	12/11/2019

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