Healthcare Provider Details

I. General information

NPI: 1033123765
Provider Name (Legal Business Name): MEDI-SYSTEMS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2006
Last Update Date: 05/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 DELLA CT
SPRING HILL FL
34606-5358
US

IV. Provider business mailing address

225 DELLA CT
SPRING HILL FL
34606-5358
US

V. Phone/Fax

Practice location:
  • Phone: 352-683-3545
  • Fax: 352-683-4236
Mailing address:
  • Phone: 352-683-3545
  • Fax: 352-683-4236

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number684
License Number StateFL

VIII. Authorized Official

Name: MRS. TAMMY MCKENZIE
Title or Position: GENERAL MANAGER
Credential:
Phone: 352-683-3545