# SUPPORT SUPPLY CO

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063406791
- **Authorized official:** ODALYS A PARDO (PRESIDENT)
- **Authorized official phone:** (305) 827-2322

## Contact information

- **Practice address:** 2115 W 60TH ST, HIALEAH, FL 33016-2616
- **Practice address phone:** (305) 827-2322
- **Practice address fax:** (305) 827-0081
- **Mailing address:** 2115 W 60TH ST, HIALEAH, FL 33016-2616
- **Mailing address phone:** (305) 827-2322
- **Mailing address fax:** (305) 827-0081

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 70 | FL | Yes |
| 332BX2000X | Oxygen Equipment & Supplies (DME) | 3202292 | FL | — |

## Other

- **Enumeration date:** 09/08/2005
- **Last updated:** 12/05/2007