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Organization
SOUTH FLORIDA MEDICAL STORE INC
Active
Organization
SOUTH FLORIDA MEDICAL STORE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIMOTHY V LEWIS (PRESIDENT)
(561) 855-7377
Entity
Organization
Contact information
Practice address
4201 WESTGATE AVE, B-14, WEST PALM BEACH, FL 33409-4719
(561) 855-7377
(561) 855-7378
Mailing address
4201 WESTGATE AVE, SUITE B-14, WEST PALM BEACH, FL 33409-4719
(561) 855-7377
(561) 855-7378
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
NULL
332BC3200X
Customized Equipment (DME)
—
NULL
332BD1200X
Dialysis Equipment & Supplies (DME)
—
NULL
332BN1400X
Nursing Facility Supplies (DME)
—
NULL
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
NULL
332BX2000X
Oxygen Equipment & Supplies (DME)
—
NULL
Other
Enumeration date
05/05/2011
Last updated
04/24/2012
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