Provider Demographics
NPI:1902564354
Name:MED SUPPLY GURUS LLC
Entity Type:Organization
Organization Name:MED SUPPLY GURUS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JADIAH
Authorized Official - Middle Name:
Authorized Official - Last Name:ECKENROD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-206-8024
Mailing Address - Street 1:4400 N FEDERAL HWY STE 40
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-3425
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4400 N FEDERAL HWY STE 40
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-3425
Practice Address - Country:US
Practice Address - Phone:561-672-1467
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-02
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies