Organization
GRQ MEDICAL SUPPLIES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SHAUN ALRIC PENN B.S.I.E (OWNER/GENERAL MANAGER)
(786) 269-9760
Entity
Organization
Contact information
Practice address
12332 SW 132ND CT, MIAMI, FL 33186-6451
(305) 969-0233
Mailing address
12332 SW 132ND CT, MIAMI, FL 33186-6451
(305) 969-0233
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
1313226
FL
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
210603220085
FL
Other
Enumeration date
07/08/2006
Last updated
07/25/2007
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