Provider Demographics
NPI:1528148459
Name:REV SUPPLY INC
Entity type:Organization
Organization Name:REV SUPPLY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICARDO
Authorized Official - Middle Name:
Authorized Official - Last Name:VILARET
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-644-8303
Mailing Address - Street 1:5836 SW 162ND PATH
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33193-5665
Mailing Address - Country:US
Mailing Address - Phone:305-644-8303
Mailing Address - Fax:
Practice Address - Street 1:5836 SW 162ND PATH
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33193-5665
Practice Address - Country:US
Practice Address - Phone:305-644-8303
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========OtherTAX ID