Healthcare Provider Details

I. General information

NPI: 1285405589
Provider Name (Legal Business Name): MMD MAJOR MEDICAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/15/2024
Last Update Date: 01/15/2024
Certification Date: 01/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4648 COMMERCIAL WAY
SPRING HILL FL
34606-1944
US

IV. Provider business mailing address

4648 COMMERCIAL WAY
SPRING HILL FL
34606-1944
US

V. Phone/Fax

Practice location:
  • Phone: 215-779-9732
  • Fax:
Mailing address:
  • Phone: 215-779-9732
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DENEEN MARGUERITE WILSON
Title or Position: ADMINISTRATION
Credential:
Phone: 215-779-9732