# DIVERSIFIED MEDICAL SUPPLY

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

## Provider details

- **NPI number:** 1568512853
- **Authorized official:** BRAD ASHTON (OWNER)
- **Authorized official phone:** (407) 398-5561

## Contact information

- **Practice address:** 478 E ALTAMONTE DR, SUITE 108, ALTAMONTE SPRINGS, FL 32701-4628
- **Practice address phone:** (407) 398-5561
- **Practice address fax:** (407) 332-8879
- **Mailing address:** 1880 DERBYSHIRE RD, MAITLAND, FL 32751-3447
- **Mailing address phone:** (407) 398-5561
- **Mailing address fax:** (407) 332-8879

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 6980136513745 | FL | Yes |

## Other

- **Enumeration date:** 01/11/2007
- **Last updated:** 08/22/2020