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General NPI Number Information
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NPI Number | 1083900765
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Entity Type | Organization
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Legal Business Name | CROWN MEDICAL SOLUTIONS, LLC
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Dates
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Enumeration Date | 06/21/2011
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Last Update Date | 06/14/2012
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Provider Practice Location Address
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Address Line | 17820 SE 109TH AVE STE 107B
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City | SUMMERFIELD
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State | FL
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Zip | 34491-8968
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Country | US
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Telephone | 855-686-0039
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Fax |
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Provider Business Mailing Address
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Address Line | 17820 SE 109TH AVE STE 107B
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City | SUMMERFIELD
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State | FL
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Zip | 34491-8968
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Country | US
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Telephone | 855-686-0039
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | TANYA COOPER
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Credential | RN
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Telephone | 270-256-0018
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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