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Organization
DIRECT MEDICAL EQUIPMENT, INC
Active
Organization
DIRECT MEDICAL EQUIPMENT, INC
Active
Other names
ONE SOURCE MEDICAL SUPPLY
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY LICA (PRESIDENT)
(954) 581-4141
Entity
Organization
Contact information
Practice address
CARR. 189 KM 3.1, BO. RINCON, GURABO, PR 00778
(787) 703-2450
(787) 703-2420
Mailing address
3300 SW 46TH AVE, DAVIE, FL 33314-2215
(954) 581-4141
(954) 797-2633
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
—
Other
Enumeration date
05/18/2006
Last updated
09/11/2025
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