| Organization Name: | SURF MEDICAL SOURCE |
| NPI Number: | 1235486200 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | TIMOTHY W FOX (MANAGER) |
| Mailing Address: | 9149 Estate Thomas Paragon Medical Building Ste 304 St Thomas |
| State: | VI US |
| Postal Code: | 008022615 |
| Phone Number: | 3407145151 |
| Fax Number: | 7083352294 |
| NPI Enumeration Date: | 08/09/2012 |
| NPI Last Update Date: | 08/31/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332BC3200X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | Customized Equipment |
| Taxonomy Definition: | |