Healthcare Provider Details

I. General information

NPI: 1992856744
Provider Name (Legal Business Name): COLTOM INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5443 SPRING HILL DR
SPRING HILL FL
34606-4563
US

IV. Provider business mailing address

5443 SPRING HILL DR
SPRING HILL FL
34606-4563
US

V. Phone/Fax

Practice location:
  • Phone: 352-686-0553
  • Fax: 353-686-0428
Mailing address:
  • Phone: 352-686-0553
  • Fax: 353-686-0428

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberOE849
License Number StateFL

VIII. Authorized Official

Name: MRS. COLLEEN FERRIS
Title or Position: PRESIDENT
Credential: D.O.
Phone: 352-686-0553