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General NPI Number Information
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NPI Number | 1225256084
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Entity Type | Organization
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Legal Business Name | PEE JAY, INC
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Dates
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Enumeration Date | 04/24/2007
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Last Update Date | 08/18/2022
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Provider Practice Location Address
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Address Line | 2521 13TH ST SUITE A
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City | SAINT CLOUD
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State | FL
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Zip | 34769-4119
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Country | US
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Telephone | 407-892-7166
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Fax | 407-892-7339
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Provider Business Mailing Address
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Address Line | 2521 13TH ST SUITE A
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City | SAINT CLOUD
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State | FL
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Zip | 34769-4119
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Country | US
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Telephone | 407-892-7166
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Fax | 407-892-7339
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | MR. ERIC J LARSON
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Credential | PHARMD
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Telephone | 407-892-7166
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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 | PH0006842
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License Number State | FL
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