Provider Demographics
NPI:1114359833
Name:ROYAL PALM MEDICAL SUPPLY INC
Entity type:Organization
Organization Name:ROYAL PALM MEDICAL SUPPLY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CF
Authorized Official - Prefix:MS
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:HARTSHORN
Authorized Official - Suffix:
Authorized Official - Credentials:COF
Authorized Official - Phone:561-253-0453
Mailing Address - Street 1:933 S MILITARY TRL STE E12
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33415-3979
Mailing Address - Country:US
Mailing Address - Phone:561-253-0453
Mailing Address - Fax:954-541-8525
Practice Address - Street 1:2393 S CONGRESS AVE
Practice Address - Street 2:SUITE 119
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33406-7628
Practice Address - Country:US
Practice Address - Phone:888-686-0011
Practice Address - Fax:877-849-9990
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-05
Last Update Date:2018-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies