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Organization

LATIN MEDICAL SUPPLY INC

Active
Other names
dba/ latin pharmacy
Organization subpart
No

Provider details

NPI number
Authorized official
JOSE E BECEIRO (PRESIDENT)
(305) 885-4214
Entity
Organization

Contact information

Practice address
240 E 1ST AVE, STE 124, HIALEAH, FL 33010-4963
(305) 885-4214
(305) 885-4215
Mailing address
240 E 1ST AVE, STE 124, HIALEAH, FL 33010-4963
(305) 885-4214
(305) 885-4215

Taxonomy

Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
FL
3336S0011X
Specialty Pharmacy
Primary
PH22896
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000925000
FL
01
1029645
NCPDP DME NUMBER
FL
01
PH22895
PHARMACY LLICENSE
FL
Enumeration date
04/18/2006
Last updated
03/07/2023
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