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General NPI Number Information
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NPI Number | 1245333574
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Entity Type | Organization
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Legal Business Name | SOUTH POINT MEDICAL SUPPLY LLC
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Dates
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Enumeration Date | 09/05/2006
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Last Update Date | 02/13/2012
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Provider Practice Location Address
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Address Line | 101 SUNNYTOWN RD SUITE 201
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City | CASSELBERRY
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State | FL
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Zip | 32707-3862
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Country | US
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Telephone | 407-830-1179
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Fax | 407-830-7775
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Provider Business Mailing Address
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Address Line | 101 SUNNYTOWN ROAD SUITE 201
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City | CASSELBERRY
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State | FL
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Zip | 32707-3862
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Country | US
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Telephone | 407-830-1179
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Fax | 407-830-7775
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Authorized Official
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Title or Position | CEO
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Name | JOHN J NOTERMANN
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Credential |
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Telephone | 407-830-1179
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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 | 1312566
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License Number State | FL
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