Provider Demographics
NPI:1629537139
Name:INTERNATIONAL MEDICAL SUPPLY, INC
Entity type:Organization
Organization Name:INTERNATIONAL MEDICAL SUPPLY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:YUDIT
Authorized Official - Middle Name:
Authorized Official - Last Name:YCASA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-760-9255
Mailing Address - Street 1:6921 SUNSET STRIP
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33313
Mailing Address - Country:US
Mailing Address - Phone:954-760-9255
Mailing Address - Fax:954-760-4741
Practice Address - Street 1:7415 NW 57TH ST
Practice Address - Street 2:
Practice Address - City:LAUDERHILL
Practice Address - State:FL
Practice Address - Zip Code:33319-2101
Practice Address - Country:US
Practice Address - Phone:954-760-9255
Practice Address - Fax:954-760-4741
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-14
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies