Provider Demographics
NPI:1194804567
Name:SS & PM INC
Entity type:Organization
Organization Name:SS & PM INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHOBHA
Authorized Official - Middle Name:
Authorized Official - Last Name:BHIDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-784-4441
Mailing Address - Street 1:1485 N ATLANTIC AVE
Mailing Address - Street 2:SUITE 111
Mailing Address - City:COCOA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32931-3244
Mailing Address - Country:US
Mailing Address - Phone:321-784-4441
Mailing Address - Fax:321-784-8212
Practice Address - Street 1:1930 PORPOISE ST
Practice Address - Street 2:
Practice Address - City:MERRITT ISLAND
Practice Address - State:FL
Practice Address - Zip Code:32952-5644
Practice Address - Country:US
Practice Address - Phone:321-784-4441
Practice Address - Fax:321-784-8212
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-04
Last Update Date:2012-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
4095580001Medicare NSC