Provider Demographics
NPI:1245336361
Name:MEDICAL SUPPLIES OF NORTH MIAMI BEACH, INC.
Entity type:Organization
Organization Name:MEDICAL SUPPLIES OF NORTH MIAMI BEACH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:R
Authorized Official - Last Name:CROUSER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:754-581-2043
Mailing Address - Street 1:16300 NE 19TH AVE
Mailing Address - Street 2:SUITE 206
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33162-4883
Mailing Address - Country:US
Mailing Address - Phone:754-581-2943
Mailing Address - Fax:
Practice Address - Street 1:16300 NE 19TH AVE
Practice Address - Street 2:SUITE 206
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33162-4883
Practice Address - Country:US
Practice Address - Phone:754-581-2943
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
N/A332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies