Healthcare Provider Details

I. General information

NPI: 1013566546
Provider Name (Legal Business Name): MEDELITE BILLING SERVICE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2019
Last Update Date: 09/07/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1563 COMMANDER RD
WESTVILLE FL
32464-3020
US

IV. Provider business mailing address

1563 COMMANDER RD
WESTVILLE FL
32464-3020
US

V. Phone/Fax

Practice location:
  • Phone: 334-248-2484
  • Fax:
Mailing address:
  • Phone: 334-248-2484
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number State

VIII. Authorized Official

Name: MARY COMMANDER
Title or Position: PRESIDENT
Credential: CPC
Phone: 334-248-2484