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General NPI Number Information
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NPI Number | 1356453286
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Entity Type | Organization
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Legal Business Name | WATSON DS, INC.
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 12/19/2014
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Provider Practice Location Address
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Address Line | 4422 LAFAYETTE ST
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City | MARIANNA
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State | FL
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Zip | 32446-3309
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Country | US
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Telephone | 850-482-4035
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Fax | 850-526-3322
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Provider Business Mailing Address
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Address Line | PO BOX 188
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City | MARIANNA
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State | FL
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Zip | 32447-0188
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Country | US
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Telephone | 850-482-4035
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Fax | 850-482-3786
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Authorized Official
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Title or Position | OWNER
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Name | PHILIP WATSON
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Credential |
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Telephone | 850-482-4035
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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 | 229
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License Number State | FL
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