Lilly Medical Supply Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

LILLY MEDICAL SUPPLY INC

Practice address

334 E 9TH St
Hialeah, FL 33010-4216

Phone

(305) 882-2704

Fax

(305) 882-2706

NPI assigned

Jul 17, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Maria Bergolle

Title

President

Phone

(786) 709-7475

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211241600000",
    "number": "1689691420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "334 E 9TH ST",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330104216",
            "telephone_number": "305-882-2704",
            "fax_number": "305-882-2706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "334 E 9TH ST",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330104216",
            "telephone_number": "305-882-2704",
            "fax_number": "305-882-2706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LILLY MEDICAL SUPPLY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-17",
        "last_updated": "2008-05-20",
        "status": "A",
        "authorized_official_last_name": "BERGOLLE",
        "authorized_official_first_name": "MARIA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "786-709-7475",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "022991100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Hialeah, FL
• Providers in Hialeah, 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 20, 2008; 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.