MEDICARE: CLIMATE CAST CONTROL, INC.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1548755549
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLIMATE CAST CONTROL, INC.

Provider Business Mailing Address
First Line	:	6650 COOLIDGE ST
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33024-3917
Country	:	US
Telephone Number	:	305-785-6761
Fax Number	:

Provider Business Practice Location Address
First Line	:	6650 COOLIDGE ST
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33024-3917
Country	:	US
Telephone Number	:	305-785-6761
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MARY DEROVANESIAN
Credential	:
Telephone Number	:	305-785-6761

Provider Enumeration Date	:	06/22/2018
Last Update Date	:	06/22/2018

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