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Organization
LILLY MEDICAL SUPPLY INC
Active
Organization
LILLY MEDICAL SUPPLY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARIA BERGOLLE (PRESIDENT)
(786) 709-7475
Entity
Organization
Contact information
Practice address
334 E 9TH ST, HIALEAH, FL 33010-4216
(305) 882-2704
(305) 882-2706
Mailing address
334 E 9TH ST, HIALEAH, FL 33010-4216
(305) 882-2704
(305) 882-2706
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
NULL
Other
Enumeration date
07/17/2006
Last updated
05/20/2008
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