Organization
MEDLIFE SUPPLY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RUSSELL JAMES INGRAM III (OWNER)
(877) 401-2142
Entity
Organization
Contact information
Practice address
1495 FOREST HILL BLVD STE C1, WEST PALM BEACH, FL 33406-6073
(877) 401-2142
(561) 770-3593
Mailing address
1495 FOREST HILL BLVD STE C1, WEST PALM BEACH, FL 33406-6073
(877) 401-2142
(561) 770-3593
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
09/28/2020
Last updated
09/28/2020
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