Provider Demographics
NPI:1588652002
Name:COMPLETE MEDICAL SUPPLIES, INC.
Entity type:Organization
Organization Name:COMPLETE MEDICAL SUPPLIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT/ OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:HETTINGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-748-1977
Mailing Address - Street 1:11971 NW 37TH ST
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-2500
Mailing Address - Country:US
Mailing Address - Phone:877-748-1977
Mailing Address - Fax:877-748-1985
Practice Address - Street 1:11971 NW 37TH ST
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-2500
Practice Address - Country:US
Practice Address - Phone:877-748-1977
Practice Address - Fax:877-748-1985
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-10
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0721816Medicaid
IA1588652002Medicaid
IN300027875Medicaid
TX30027875Medicaid
AZ548264Medicaid
MD580288100Medicaid
NC1588652002Medicaid
ME1588652002Medicaid
WA2178303Medicaid
KY7100631250Medicaid
RI1588652002Medicaid
UT3015340Medicaid
WI100096794Medicaid
MA1101614891AMedicaid
MI1588652002Medicaid
NM17134030Medicaid
OR500774457Medicaid
FL030810200Medicaid
NH3124758Medicaid
CO9000179349Medicaid
OH0370750Medicaid
NE100268770200Medicaid
VT1035830Medicaid
ID1588652002Medicaid
KS30004676390001Medicaid
SCDM1611Medicaid