Organization
PREMIUM MEDICAL EQUIPMENT SUPPLIES CORP
Active
Other names
Premium Pharmacy & Medical Supplies
Organization subpart
No
Provider details
NPI number
Authorized official
YULIEMNI ESPINOSA (PRESIDENT)
(305) 825-6183
Entity
Organization
Contact information
Practice address
11400 W. FLAGER ST, SUITE #108, SWEETWATER, FL 33174
(305) 825-6183
(305) 826-4997
Mailing address
11400 W. FLAGER ST, SUITE #108, SWEETWATER, FL 33174
(305) 825-6183
(305) 826-4997
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PH22467
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000309000
—
FL
05
—
001309001
—
FL
01
—
2008296
PK
—
Enumeration date
06/19/2006
Last updated
08/02/2018
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