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General NPI Number Information
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NPI Number | 1023246956
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Entity Type | Organization
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Legal Business Name | MEDQUEST MEDICAL SUPPLIES LLC
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Dates
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Enumeration Date | 06/30/2009
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Last Update Date | 06/30/2009
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Provider Practice Location Address
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Address Line | 1310-A NORTH SHORE DR
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City | LEESBURG
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State | FL
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Zip | 34748-3536
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Country | US
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Telephone | 352-315-1651
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Fax |
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Provider Business Mailing Address
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Address Line | 1310-A NORTH SHORE DR
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City | LEESBURG
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State | FL
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Zip | 34748-3536
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Country | US
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Telephone | 352-315-1651
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MR. RAYMOND DOMINICK
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Credential |
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Telephone | 352-315-1651
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number |
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License Number State |
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