Organization Name: | MEDIQUIP REHABILITATIVE EQUIPMENT AND SUPPLIES |
NPI Number: | 1043418593 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KRISTI R JORDAN (CEO) |
Mailing Address: | 2084 Rex Rd Suite 3 Lake City |
State: | GA US |
Postal Code: | 302603960 |
Phone Number: | 4043629855 |
Fax Number: | 4043629856 |
NPI Enumeration Date: | 07/06/2007 |
NPI Last Update Date: | 04/07/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | |
Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |