Pro Medical Supply LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

PRO MEDICAL SUPPLY LLC

Practice address

2101 Vista Pkwy Ste 112
West Palm Beach, FL 33411-2706

Phone

(561) 628-1165

NPI assigned

Oct 25, 2018

Organization subpart

No

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

Authorized official

Name

Mr. Joel Rendon

Title

Manager

Phone

(561) 628-1165

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1540425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563840000000",
    "number": "1912474222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 VISTA PKWY STE 216",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334112706",
            "telephone_number": "561-628-1165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 VISTA PKWY STE 112",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334112706",
            "telephone_number": "561-628-1165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRO MEDICAL SUPPLY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-25",
        "last_updated": "2019-07-23",
        "status": "A",
        "authorized_official_last_name": "RENDON",
        "authorized_official_first_name": "JOEL",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "561-628-1165",
        "authorized_official_name_prefix": "Mr."
    },
    "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 West Palm Beach, FL
• Providers in West Palm 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 Jul 23, 2019; 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.