Provider Demographics
NPI:1902353634
Name:CORE MEDICAL SUPPLY,LLC
Entity Type:Organization
Organization Name:CORE MEDICAL SUPPLY,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PIERRE
Authorized Official - Middle Name:A
Authorized Official - Last Name:PLANCHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-440-9094
Mailing Address - Street 1:1107 NW 15TH ST
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33311-5428
Mailing Address - Country:US
Mailing Address - Phone:239-440-9094
Mailing Address - Fax:
Practice Address - Street 1:1107 NW 15TH ST
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33311-5428
Practice Address - Country:US
Practice Address - Phone:239-440-9094
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-11
Last Update Date:2016-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1680170559237332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies