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NPI Code Detail

MEDICARE: HIALEAH MEDICAL SUPPLIES CORP

MEDICARE: HIALEAH MEDICAL SUPPLIES CORP
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
1332B00000XDurable Medical Equipment & Medical Supplies
23336C0003XCommunity/Retail PharmacyPH22841FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11033555OTHEROTHER ID NUMBER

General Provider Information

NPI Number : 1952408163
Entity Type Code : Organization
Provider Name (Legal Business Name) : HIALEAH MEDICAL SUPPLIES CORP
Provider Business Mailing Address
First Line : 8325 W 24TH AVE STE 7
Second Line :
City : HIALEAH
State : FL
Zip : 33016-1880
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 8325 W 24TH AVE STE 7
Second Line :
City : HIALEAH
State : FL
Zip : 33016-1880
Country : US
Telephone Number : 305-362-4118
Fax Number : 305-362-4514
Authorized Official
Title or Position : PRESIDENT
Name : PEDRO MANGANO
Credential :
Telephone Number : 305-362-4118
Provider Enumeration Date : 09/20/2006
Last Update Date : 03/31/2008

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Directions to “HIALEAH MEDICAL SUPPLIES CORP ” Practice Location

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