# PREMIUM MEDICAL SUPPLY INC

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

## Provider details

- **NPI number:** 1316160831
- **Authorized official:** FRANCISCO DE LA CRUZ (PRESIDENT)
- **Authorized official phone:** (305) 792-2540

## Contact information

- **Practice address:** 955 SW 122ND AVE, MIAMI, FL 33184-2406
- **Practice address phone:** (305) 227-8727
- **Mailing address:** 955 SW 122ND AVE, MIAMI, FL 33184-2406
- **Mailing address phone:** (305) 227-8727

## Taxonomy

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

## Other

- **Enumeration date:** 04/11/2007
- **Last updated:** 08/22/2020