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Organization
SUPPORT SUPPLY CO
Active
Organization
SUPPORT SUPPLY CO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ODALYS A PARDO (PRESIDENT)
(305) 827-2322
Entity
Organization
Contact information
Practice address
2115 W 60TH ST, HIALEAH, FL 33016-2616
(305) 827-2322
(305) 827-0081
Mailing address
2115 W 60TH ST, HIALEAH, FL 33016-2616
(305) 827-2322
(305) 827-0081
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
70
FL
332BX2000X
Oxygen Equipment & Supplies (DME)
3202292
FL
Other
Enumeration date
09/08/2005
Last updated
12/05/2007
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