Healthcare Provider Details

I. General information

NPI: 1780388033
Provider Name (Legal Business Name): SERENITY PUMPS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2023
Last Update Date: 10/22/2024
Certification Date: 10/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 GULF BREEZE PKWY STE 352
GULF BREEZE FL
32561-4862
US

IV. Provider business mailing address

PO BOX 236
LARKSPUR CO
80118-0236
US

V. Phone/Fax

Practice location:
  • Phone: 719-967-9500
  • Fax: 855-933-1188
Mailing address:
  • Phone: 719-967-9500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code247000000X
TaxonomyHealth Information Technician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MR. JOHN FOSTER
Title or Position: CEO
Credential:
Phone: 719-967-9500