S & T Medical Supply Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

1644 Issued in FL

Legal business name

S & T MEDICAL SUPPLY INC.

Practice address

11054 S Military TRL
Boynton Beach, FL 33436-7217

Phone

(561) 364-2600

Fax

(561) 364-2199

NPI assigned

Oct 31, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Natalia Prohorova

Title

Vice President

Phone

(561) 364-2600

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Southeast Mobility Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Esther Street

  • Durable Medical Equipment & Medical Supplies
  • Boynton Beach, FL
  • NPI 1851324008
  NPD (past)

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

{
    "created_epoch": "1193788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683244800000",
    "number": "1508045105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11054 S MILITARY TRL",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334367217",
            "telephone_number": "561-364-2600",
            "fax_number": "561-364-2199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11054 S MILITARY TRL",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334367217",
            "telephone_number": "561-364-2600",
            "fax_number": "561-364-2199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "S & T MEDICAL SUPPLY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-31",
        "last_updated": "2023-05-05",
        "certification_date": "2023-05-05",
        "status": "A",
        "authorized_official_last_name": "PROHOROVA",
        "authorized_official_first_name": "NATALIA",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "561-364-2600",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "FL",
            "license": "1644",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "R9769",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "031702100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID",
            "identifier": "0317021 00",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southeast Mobility",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Southeast Mobility",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Durable Medical Equipment & Medical Supplies in Boynton Beach, FL
• Providers in Boynton 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 May 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.