Organization
DIRECT MEDICAL EQUIPMENT, INC
Active
Other names
ONE SOURCE MEDICAL SUPPLY
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY LICA (PRESIDENT)
(954) 581-4141
Entity
Organization
Contact information
Practice address
CARR. 189 KM 3.1, BO. RINCON, GURABO, PR 00778
(787) 703-2450
(787) 703-2420
Mailing address
3300 SW 46TH AVE, DAVIE, FL 33314-2215
(954) 581-4141
(954) 797-2633
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
—
Other
Enumeration date
05/18/2006
Last updated
09/11/2025
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