Georgia Medical Supply Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

GEORGIA MEDICAL SUPPLY INC

Practice address

3450 W 84TH St
102-C
Hialeah, FL 33018-4924

Phone

(786) 768-1499

Fax

(305) 477-6518

NPI assigned

Nov 15, 2006

Organization subpart

No

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

Authorized official

Name

Nolberto Pelaez

Title

President

Phone

(786) 768-1499

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1962574525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3450 W 84TH ST",
            "address_2": "102-C",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330184924",
            "telephone_number": "786-768-1499",
            "fax_number": "305-477-6518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3450 W 84TH ST",
            "address_2": "102-C",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330184924",
            "telephone_number": "786-768-1499",
            "fax_number": "305-477-6518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGIA MEDICAL SUPPLY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PELAEZ",
        "authorized_official_first_name": "NOLBERTO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "786-768-1499"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EIN",
            "identifier": "2057698887",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.