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General NPI Number Information
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NPI Number | 1386606481
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Entity Type | Organization
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Legal Business Name | MASH INC
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Dates
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Enumeration Date | 04/04/2006
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Last Update Date | 07/14/2015
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Provider Practice Location Address
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Address Line | 1505 B SOUTH FERDON BLVD
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City | CRESTVIEW
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State | FL
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Zip | 32536
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Country | US
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Telephone | 850-682-9777
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Fax | 850-682-2996
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Provider Business Mailing Address
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Address Line | 1505 B SOUTH FERDON BLVD
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City | CRESTVIEW
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State | FL
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Zip | 32536
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Country | US
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Telephone | 850-682-9777
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Fax | 850-682-2996
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. GREGORY L HORN
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Credential |
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Telephone | 205-664-2059
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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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