Provider Demographics
NPI:1215799697
Name:CARDINAL MEDICAL SUPPLY LLC
Entity type:Organization
Organization Name:CARDINAL MEDICAL SUPPLY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:
Authorized Official - Last Name:PARRISH
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:239-206-2959
Mailing Address - Street 1:390 HAWSER LN
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-5078
Mailing Address - Country:US
Mailing Address - Phone:239-216-0695
Mailing Address - Fax:832-218-1801
Practice Address - Street 1:2335 TAMIAMI TRL N STE 208B
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34103-4457
Practice Address - Country:US
Practice Address - Phone:239-206-2959
Practice Address - Fax:832-218-1801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-30
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy