# BASE MEDICAL SUPPLY INC.

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

## Provider details

- **NPI number:** 1275042483
- **Authorized official:** MR. CLIFFORD TODD MONAGHAN (CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (772) 618-1183

## Contact information

- **Practice address:** 130 S INDIAN RIVER DR STE 202, FORT PIERCE, FL 34950-4353
- **Practice address phone:** (772) 618-1183
- **Practice address fax:** (772) 672-3014
- **Mailing address:** 130 S INDIAN RIVER DR STE 202, FORT PIERCE, FL 34950-4353
- **Mailing address phone:** (772) 618-1183
- **Mailing address fax:** (772) 672-3014

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | Yes |

## Other

- **Enumeration date:** 09/20/2017
- **Last updated:** 07/21/2022