Equilibrium Medical Supply Inc

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

License

PO 3232 Issued in FL

Legal business name

EQUILIBRIUM MEDICAL SUPPLY INC

Practice address

2100 E Hallandale Beach Blvd
Suite 301
Hallandale Beach, FL 33009-3765

Phone

(954) 455-2190

Fax

(954) 455-5997

NPI assigned

May 9, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Jeremy Waxman

Title

President

Phone

(954) 455-2190

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1147132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257206400000",
    "number": "1902855752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 E HALLANDALE BEACH BLVD",
            "address_2": "SUITE 301",
            "city": "HALLANDALE BEACH",
            "state": "FL",
            "postal_code": "330093765",
            "telephone_number": "954-455-2190",
            "fax_number": "954-455-5997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 E HALLANDALE BEACH BLVD",
            "address_2": "SUITE 301",
            "city": "HALLANDALE BEACH",
            "state": "FL",
            "postal_code": "330093765",
            "telephone_number": "954-455-2190",
            "fax_number": "954-455-5997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EQUILIBRIUM MEDICAL SUPPLY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-09",
        "last_updated": "2009-11-03",
        "status": "A",
        "authorized_official_last_name": "WAXMAN",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-455-2190",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "FL",
            "license": "PO 3232",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Prosthetic/Orthotic Supplier in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2009; 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.