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General NPI Number Information
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NPI Number | 1235381682
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Entity Type | Organization
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Legal Business Name | GILLIGAN AND FERNEMAN LLC
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Dates
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Enumeration Date | 10/16/2008
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Last Update Date | 10/16/2008
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Provider Practice Location Address
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Address Line | 7328 THOMAS DR SUITE B
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City | PANAMA CITY BEACH
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State | FL
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Zip | 32408-7500
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Country | US
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Telephone | 850-588-8695
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Fax | 850-588-8696
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Provider Business Mailing Address
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Address Line | PO BOX 9166
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City | PANAMA CITY BEACH
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State | FL
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Zip | 32417-9166
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Country | US
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Telephone | 850-588-8695
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Fax | 850-588-8696
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Authorized Official
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Title or Position | CO-OWNER
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Name | MR. MICHAEL STIG FERNEMAN
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Credential |
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Telephone | 850-532-3640
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State |
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