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General NPI Number Information
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NPI Number | 1124159728
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Entity Type | Organization
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Legal Business Name | DURAMED MEDICAL SERVICES
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Dates
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Enumeration Date | 03/08/2007
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Last Update Date | 02/13/2012
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Provider Practice Location Address
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Address Line | 289 SW RANGE AVE STE D
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City | MADISON
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State | FL
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Zip | 32340
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Country | US
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Telephone | 850-973-8116
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Fax | 850-973-8118
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Provider Business Mailing Address
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Address Line | 602 NE BLUE RIDGE LANDING AVE
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City | LEE
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State | FL
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Zip | 32059
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Country | US
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Telephone | 850-973-8116
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Fax | 850-973-8118
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Authorized Official
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Title or Position | PROPRIETOR
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Name | MR. BISHOP LEE MCMILLER
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Credential | RRT REGISTERED RESPI
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Telephone | 850-973-8116
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 293D00000X
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Taxonomy Name | Physiological Laboratory
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License Number | HCC4268
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License Number State | FL
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