# EMERALD MEDICAL SUPPLY, INC

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

## Provider details

- **NPI number:** 1588179097
- **Authorized official:** JONATHAN TANNER (OWNER)
- **Authorized official phone:** (727) 351-7058

## Contact information

- **Practice address:** 19455 GULF BLVD STE 5, INDIAN SHORES, FL 33785-2000
- **Practice address phone:** (727) 351-7058
- **Mailing address:** 19455 GULF BLVD STE 5, INDIAN SHORES, FL 33785-2000
- **Mailing address phone:** (727) 351-7058
- **Mailing address fax:** (727) 509-3073

## Taxonomy

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

## Other

- **Enumeration date:** 12/06/2017
- **Last updated:** 04/28/2018