MEDICARE: PALMER MEDICAL SUPPLIES, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	225000000X	Orthotic Fitter
2	227900000X	Registered Respiratory Therapist
3	224900000X	Mastectomy Fitter
4	332BX2000X	Oxygen Equipment & Supplies (DME)
5	332B00000X	Durable Medical Equipment & Medical Supplies

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	R8213	OTHER	FL	BLUE CROSS BLUE SHIELD OF
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457432338
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PALMER MEDICAL SUPPLIES, INC

Provider Business Mailing Address
First Line	:	2686 CHAPMAN DRIVE
Second Line	:
City	:	PANAMA CITY
State	:	FL
Zip	:	32405
Country	:	US
Telephone Number	:	850-784-0070
Fax Number	:	850-784-2800

Provider Business Practice Location Address
First Line	:	2686 CHAPMAN DRIVE
Second Line	:
City	:	PANAMA CITY
State	:	FL
Zip	:	32405
Country	:	US
Telephone Number	:	850-784-0070
Fax Number	:	850-784-2800

Authorized Official
Title or Position	:	OWNER/MANAGER
Name	:	MRS. TAMARA A. LILLARD
Credential	:
Telephone Number	:	850-784-0070

Provider Enumeration Date	:	10/18/2006
Last Update Date	:	01/13/2014

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