Organization Name: | SUPERMED INC |
NPI Number: | 1083616098 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | PHILLIP BANE (PRESIDENT) |
Mailing Address: | 525 Shadow Lakes Blvd Ormond Beach |
State: | FL US |
Postal Code: | 321745003 |
Phone Number: | 3866729530 |
Fax Number: | 3866772072 |
NPI Enumeration Date: | 08/10/2005 |
NPI Last Update Date: | 02/12/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332BX2000X |
License Number: | HME868 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | FL |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | Oxygen Equipment & Supplies |
Taxonomy Definition: |