Healthcare Provider Details

I. General information

NPI: 1457432338
Provider Name (Legal Business Name): PALMER MEDICAL SUPPLIES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2006
Last Update Date: 01/13/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2686 CHAPMAN DRIVE
PANAMA CITY FL
32405
US

IV. Provider business mailing address

2686 CHAPMAN DRIVE
PANAMA CITY FL
32405
US

V. Phone/Fax

Practice location:
  • Phone: 850-784-0070
  • Fax: 850-784-2800
Mailing address:
  • Phone: 850-784-0070
  • Fax: 850-784-2800

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225000000X
TaxonomyOrthotic Fitter
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code224900000X
TaxonomyMastectomy Fitter
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MRS. TAMARA A. LILLARD
Title or Position: OWNER/MANAGER
Credential:
Phone: 850-784-0070