Medlife Supply LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

MEDLIFE SUPPLY LLC

Practice address

1495 Forest Hill Blvd Ste C1
West Palm Beach, FL 33406-6073

Phone

(877) 401-2142

Fax

(561) 770-3593

NPI assigned

Sep 28, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Russell James Ingram III

Title

Owner

Phone

(877) 401-2142

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1601251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601251200000",
    "number": "1043827694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1495 FOREST HILL BLVD STE C1",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334066073",
            "telephone_number": "877-401-2142",
            "fax_number": "561-770-3593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1495 FOREST HILL BLVD STE C1",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334066073",
            "telephone_number": "877-401-2142",
            "fax_number": "561-770-3593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDLIFE SUPPLY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-28",
        "last_updated": "2020-09-28",
        "certification_date": "2020-09-28",
        "status": "A",
        "authorized_official_last_name": "INGRAM",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "877-401-2142",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in West Palm Beach, FL
• Providers in West Palm Beach, FL by specialty
• Durable Medical Equipment & Medical Supplies in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.