Medultra Supplies, LLC

Primary specialty

Nursing Facility Supplies (DME)Taxonomy code 332BN1400X

Legal business name

MEDULTRA SUPPLIES, LLC

Practice address

1232 Falls Blvd
Weston, FL 33327-1723

Phone

(561) 342-1161

NPI assigned

Feb 13, 2012

Organization subpart

No

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

Authorized official

Name

Mr. Salomon Mizrahi

Title

Director

Phone

(561) 342-1161

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1329091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329091200000",
    "number": "1578836136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1232 FALLS BLVD",
            "city": "WESTON",
            "state": "FL",
            "postal_code": "333271723",
            "telephone_number": "561-342-1161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1232 FALLS BLVD",
            "city": "WESTON",
            "state": "FL",
            "postal_code": "333271723",
            "telephone_number": "561-342-1161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDULTRA SUPPLIES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-13",
        "last_updated": "2012-02-13",
        "status": "A",
        "authorized_official_last_name": "MIZRAHI",
        "authorized_official_first_name": "SALOMON",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "561-342-1161",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332BN1400X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nursing Facility Supplies (DME) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2012; 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.