Provider Demographics
NPI:1730371949
Name:ADM MEDICAL SUPPLIES & EQUIPMENT LLC
Entity type:Organization
Organization Name:ADM MEDICAL SUPPLIES & EQUIPMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TINA MARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHARTRAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-445-7463
Mailing Address - Street 1:11201 PARK BLVD STE 71
Mailing Address - Street 2:
Mailing Address - City:SEMINOLE
Mailing Address - State:FL
Mailing Address - Zip Code:33772-4760
Mailing Address - Country:US
Mailing Address - Phone:727-445-7463
Mailing Address - Fax:866-591-7463
Practice Address - Street 1:11201 PARK BLVD STE 71
Practice Address - Street 2:
Practice Address - City:SEMINOLE
Practice Address - State:FL
Practice Address - Zip Code:33772-4760
Practice Address - Country:US
Practice Address - Phone:727-445-7463
Practice Address - Fax:866-591-7463
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-11
Last Update Date:2010-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL5996650001Medicare UPIN
FL5996650001Medicare PIN
FL5996650001Medicare NSC