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General NPI Number Information
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NPI Number | 1316901259
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Entity Type | Organization
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Legal Business Name | GULFCOAST MEDICAL SUPPLY INC
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Dates
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Enumeration Date | 04/17/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 2455 N MCMULLEN BOOTH RD SUITE A
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City | CLEARWATER
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State | FL
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Zip | 33759-1358
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Country | US
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Telephone | 727-791-7404
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Fax | 727-712-2220
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Provider Business Mailing Address
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Address Line | PO BOX 16851
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City | CLEARWATER
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State | FL
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Zip | 33766-6851
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Country | US
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Telephone | 727-791-7404
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Fax | 727-712-2220
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Authorized Official
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Title or Position | PRESIDENT
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Name | JON R DODDS
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Credential |
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Telephone | 727-791-7404
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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 | HME 1411
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number | 32-04508
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License Number State | FL
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