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General NPI Number Information
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NPI Number | 1154531523
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Entity Type | Organization
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Legal Business Name | MEDICAL ONE, LLC
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Dates
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Enumeration Date | 05/23/2007
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Last Update Date | 02/08/2010
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Provider Practice Location Address
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Address Line | 620 OLIVER ROAD SUITE E
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City | MONTGOMERY
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State | AL
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Zip | 36117
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Country | US
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Telephone | 334-421-8826
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Fax |
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Provider Business Mailing Address
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Address Line | 620 OLIVER ROAD SUITE E
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City | MONTGOMERY
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State | AL
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Zip | 36117
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Country | US
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Telephone | 334-421-8826
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. RICO MAURICE DURHAM
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Credential |
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Telephone | 334-421-8826
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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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