Provider Demographics
NPI:1962264531
Name:LAS OLAS MEDICAL SUPPLY INC
Entity type:Organization
Organization Name:LAS OLAS MEDICAL SUPPLY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:JELAMBI GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:754-201-2711
Mailing Address - Street 1:750 E SAMPLE RD
Mailing Address - Street 2:SUITE 207
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33064-5144
Mailing Address - Country:US
Mailing Address - Phone:754-201-2711
Mailing Address - Fax:754-247-3771
Practice Address - Street 1:750 E SAMPLE RD
Practice Address - Street 2:SUITE 207
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33064-5144
Practice Address - Country:US
Practice Address - Phone:754-201-2711
Practice Address - Fax:754-247-3771
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-29
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies