Organization
ABACOA MEDICAL SUPPLIES INC
Active
Other names
Abacoa Medical Supplies, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
LAWRENCE A DICKSON (PRESIDENT)
(561) 994-2302
Entity
Organization
Contact information
Practice address
3100 NW BOCA RATON BLVD STE 213, BOCA RATON, FL 33431-6658
(561) 994-2302
(888) 204-4514
Mailing address
3100 NW BOCA RATON BLVD STE 213, BOCA RATON, FL 33431-6658
(561) 994-2302
(888) 204-4514
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
2018106632
FL
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003227252A
—
GA
05
—
006058509
—
MS
05
—
006887
—
HI
05
—
0393111
—
OH
05
—
067848214
—
DC
05
—
0698636
—
NJ
05
—
100092814
—
WI
05
—
10026761200
—
NE
05
—
101491800
—
FL
05
—
1036577000001
—
PA
05
—
1480327
—
ND
05
—
151768600
—
WY
05
—
200806460A
—
OK
05
—
2124621
—
WA
01
—
2177429
PK
—
05
—
225119
—
AL
05
—
234796741
—
AR
05
—
2483871
—
LA
05
—
250572523
—
DE
05
—
282023400
—
MD
05
—
300019499
—
IN
05
—
30004619230001
—
KS
05
—
3002474
—
SD
05
—
396703601
—
TX
05
—
435148
—
AZ
05
—
500758565
—
OR
05
—
53407334
—
NM
01
—
5737727
NCPDP
—
05
—
620065893
—
MO
05
—
6710681
—
VT
05
—
7100570080
—
KY
05
—
900017037
—
CO
05
—
937133
—
CA
05
—
DM1616
—
SC
01
—
NPC-0004670
BOARD OF PHARMACY
OR
05
—
Q047492
—
TN
Enumeration date
04/25/2018
Last updated
05/15/2024
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