Healthcare Provider Details
I. General information
NPI: 1457396376
Provider Name (Legal Business Name): MRB ACQUISITION CORP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/17/2006
Last Update Date: 10/21/2025
Certification Date: 10/21/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1898 S CLYDE MORRIS BLVD SUITE 410
DAYTONA BEACH FL
32119-1584
US
IV. Provider business mailing address
19387 US HIGHWAY 19 N
CLEARWATER FL
33764-3102
US
V. Phone/Fax
- Phone: 866-387-2668
- Fax: 386-254-2844
- Phone: 727-530-7700
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | 8519 |
| License Number State | FL |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332BC3200X |
| Taxonomy | Customized Equipment (DME) |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332BX2000X |
| Taxonomy | Oxygen Equipment & Supplies (DME) |
| License Number | 32:04483 |
| License Number State | FL |
VIII. Authorized Official
Name:
JEFFREY
BARNHARD
Title or Position: CEO
Credential: AO
Phone: 727-530-7700