Provider Demographics
NPI:1063579944
Name:MEDICAL EQUIPMENT DISTRIBUTION & SUPPLY CORP
Entity type:Organization
Organization Name:MEDICAL EQUIPMENT DISTRIBUTION & SUPPLY CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:HUGO
Authorized Official - Last Name:PEREYRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-646-9816
Mailing Address - Street 1:215 SW 17TH AVE
Mailing Address - Street 2:313
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33135-3689
Mailing Address - Country:US
Mailing Address - Phone:305-646-9816
Mailing Address - Fax:305-646-9817
Practice Address - Street 1:215 SW 17TH AVE
Practice Address - Street 2:313
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-3689
Practice Address - Country:US
Practice Address - Phone:305-646-9816
Practice Address - Fax:305-646-9817
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies