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General NPI Number Information
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NPI Number | 1306856687
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Entity Type | Organization
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Legal Business Name | NORMA L. GARY
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Dates
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Enumeration Date | 08/09/2006
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Last Update Date | 02/21/2008
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Provider Practice Location Address
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Address Line | 16770 S US 441 STE 601
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City | SUMMERFIELD
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State | FL
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Zip | 34491
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Country | US
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Telephone | 352-347-7855
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Fax | 352-347-7856
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Provider Business Mailing Address
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Address Line | 16770 S US 441 STE 601
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City | SUMMERFIELD
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State | FL
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Zip | 34491
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Country | US
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Telephone | 352-347-7855
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Fax | 352-347-7856
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Authorized Official
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Title or Position | OWNER/CERTIFIED MASTECTOMY FITTER
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Name | MRS. NORMA LORRAINE GARY
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Credential | ABC CERTIFICATION
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Telephone | 352-347-7855
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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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