# ICONIC MEDICAL SUPPLIES AND SERVICES INC

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

## Provider details

- **NPI number:** 1912612425
- **Authorized official:** MS. CARRA RUSSELL (OWNER/PRESIDENT)
- **Authorized official phone:** (561) 541-8586

## Contact information

- **Practice address:** 1860 FOREST HILL BLVD STE 204, WEST PALM BEACH, FL 33406-6086
- **Practice address phone:** (561) 541-8586
- **Mailing address:** 1860 FOREST HILL BLVD STE 204, WEST PALM BEACH, FL 33406-6086
- **Mailing address phone:** (561) 541-8586

## Taxonomy

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

## Other

- **Enumeration date:** 01/18/2023
- **Last updated:** 07/03/2024