Provider Demographics
NPI:1598786543
Name:AMERIMEDZ II
Entity type:Organization
Organization Name:AMERIMEDZ II
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MGR
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:METZLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-833-6690
Mailing Address - Street 1:4047 OKEECHOBEE BLVD
Mailing Address - Street 2:217
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-3239
Mailing Address - Country:US
Mailing Address - Phone:561-833-9960
Mailing Address - Fax:561-835-1201
Practice Address - Street 1:4047 OKEECHOBEE BLVD STE 217
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409-3237
Practice Address - Country:US
Practice Address - Phone:561-833-9960
Practice Address - Fax:561-835-1201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2015-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336M0002X, 332B00000X, 333600000X, 3336S0011X
FLPH215753336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No3336M0002XSuppliersPharmacyMail Order Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL031199500Medicaid
2005741OtherPK
FL031199500Medicaid