Skybridge Med Supply LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

SKYBRIDGE MED SUPPLY LLC

Practice address

111 E Monument Ave Unit 405
Kissimmee, FL 34741-5774

Phone

(800) 488-7326

Fax

(321) 250-5461

NPI assigned

Mar 8, 2022

Organization subpart

No

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

Authorized official

Name

Kenneth Chrysostome

Title

Owner

Phone

(561) 762-4440

Specialties & licenses 1

Addresses

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

• Kissimmee Med Supply LLC

  • Durable Medical Equipment & Medical Supplies
  • Kissimmee, FL
  • NPI 1841947033

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1646697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646697600000",
    "number": "1366199481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 E MONUMENT AVE UNIT 405",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347415774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 E MONUMENT AVE UNIT 405",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347415774",
            "telephone_number": "800-488-7326",
            "fax_number": "321-250-5461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKYBRIDGE MED SUPPLY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-08",
        "last_updated": "2022-03-08",
        "certification_date": "2022-03-08",
        "status": "A",
        "authorized_official_last_name": "CHRYSOSTOME",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "561-762-4440"
    },
    "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 Kissimmee, FL
• Providers in Kissimmee, 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 Mar 8, 2022; 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.