MEDICARE: EXCELLENT HOME MEDICAL EQUIPMENT CORP.

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	333600000X	Pharmacy	PH28010	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1039177	OTHER		NCPDP PROVIDER IDENTIFICATION NUMBER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1982657383
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EXCELLENT HOME MEDICAL EQUIPMENT CORP.

Provider Business Mailing Address
First Line	:	18555 SW 104TH AVE
Second Line	:
City	:	CUTLER BAY
State	:	FL
Zip	:	33157-6847
Country	:	US
Telephone Number	:	305-382-0116
Fax Number	:	305-382-0129

Provider Business Practice Location Address
First Line	:	9961 SW 142ND AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33186-6844
Country	:	US
Telephone Number	:	305-382-0116
Fax Number	:	305-382-0129

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. ALEXANDER DOBARGANES
Credential	:
Telephone Number	:	305-382-0116

Provider Enumeration Date	:	05/18/2006
Last Update Date	:	09/16/2015

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Directions to “EXCELLENT HOME MEDICAL EQUIPMENT CORP. ” Practice Location

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