=====================================================
General NPI Number Information
=====================================================
NPI Number | 1104229319
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MEDICAL NECESSITIES & SERVICES LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/01/2014
-----------------------------------------------------
Last Update Date | 06/08/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 18 REGENT PARK BLVD STE E
-----------------------------------------------------
City | ASHEVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28806-3727
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 864-000-0000
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3325 BARTLETT BLVD
-----------------------------------------------------
City | ORLANDO
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32811-6428
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-206-0040
-----------------------------------------------------
Fax | 407-206-0010
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO/ PRESIDENT
-----------------------------------------------------
Name | MR. STEPHEN GRIGGS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 407-206-0040
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332B00000X
-----------------------------------------------------
Taxonomy Name | Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 332BX2000X
-----------------------------------------------------
Taxonomy Name | Oxygen Equipment & Supplies (DME)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------