Provider Demographics
NPI:1053881490
Name:ACACIA DME LLC
Entity type:Organization
Organization Name:ACACIA DME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KEISHA
Authorized Official - Middle Name:DME
Authorized Official - Last Name:SUCKIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-624-5392
Mailing Address - Street 1:2101 VISTA PKWY STE 133
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-2706
Mailing Address - Country:US
Mailing Address - Phone:954-624-5392
Mailing Address - Fax:
Practice Address - Street 1:2101 VISTA PKWY STE 133
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-2706
Practice Address - Country:US
Practice Address - Phone:954-624-5392
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-28
Last Update Date:2019-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies