Organization
MEDICAL SUPPLY STORE #1
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BEN ZION KUNCMAN (CEO)
(954) 933-9137
Entity
Organization
Contact information
Practice address
1831 N UNIVERSITY DR, CORAL SPRINGS, FL 33071-6001
(954) 933-9137
(954) 752-9447
Mailing address
1831 N UNIVERSITY DR, CORAL SPRINGS, FL 33071-6001
(954) 933-9137
(954) 752-9447
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
1313370
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R9710
BCBS
FL
Enumeration date
10/04/2006
Last updated
03/03/2009
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