Organization Name: | MED-SOURCE OF CENTRAL FLORIDA, INC |
NPI Number: | 1104852995 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LAURIE BOWLING (OWNER/PRESIDENT) |
Mailing Address: | 1495 S Volusia Ave Suite 101 Orange City |
State: | FL US |
Postal Code: | 327637047 |
Phone Number: | 3867748900 |
Fax Number: | 3867742040 |
NPI Enumeration Date: | 06/23/2006 |
NPI Last Update Date: | 08/27/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332BX2000X |
License Number: | 2001 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | Oxygen Equipment & Supplies |
Taxonomy Definition: |