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General NPI Number Information
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NPI Number | 1093131344
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Entity Type | Organization
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Legal Business Name | ONDEMAND MEDICAL
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Dates
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Enumeration Date | 03/11/2014
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Last Update Date | 03/11/2014
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Provider Practice Location Address
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Address Line | 6266 S CONGRESS AVE
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City | LAKE WORTH
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State | FL
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Zip | 33462-2375
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Country | US
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Telephone | 561-396-4075
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Fax |
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Provider Business Mailing Address
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Address Line | 2212 SE 4TH ST
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City | BOYNTON BEACH
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State | FL
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Zip | 33435-7214
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Country | US
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Telephone | 561-396-4075
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. MARQUITA JERMAREO STEPHENS
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Credential |
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Telephone | 561-396-4075
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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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