Healthcare Provider Details

I. General information

NPI: 1386630200
Provider Name (Legal Business Name): AFFORDABLE MEDICAL EQUIPMENT SOLUTION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2005
Last Update Date: 06/24/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6930 BONNEVAL RD SUITE 3
JACKSONVILLE FL
32216-6012
US

IV. Provider business mailing address

3223 SUNSET BLVD SUITE 104
WEST COLUMBIA SC
29169-3200
US

V. Phone/Fax

Practice location:
  • Phone: 904-674-2100
  • Fax: 904-674-2105
Mailing address:
  • Phone: 803-936-9376
  • Fax: 803-936-9872

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number1312127
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number326736
License Number StateFL

VIII. Authorized Official

Name: MR. MADHU M MATHEW
Title or Position: CEO
Credential:
Phone: 803-936-9376