Healthcare Provider Details

I. General information

NPI: 1699761999
Provider Name (Legal Business Name): KELMEDIX INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2005
Last Update Date: 12/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4646 COMMERCIAL WAY
SPRING HILL FL
34606
US

IV. Provider business mailing address

4646 COMMERCIAL WAY
SPRING HILL FL
34606
US

V. Phone/Fax

Practice location:
  • Phone: 352-592-1063
  • Fax: 352-592-1064
Mailing address:
  • Phone: 352-592-1063
  • Fax: 352-592-1064

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number3700016853797
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MRS. SHARON J SWANSTON
Title or Position: COO
Credential:
Phone: 352-592-1063