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General NPI Number Information
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NPI Number | 1396329538
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Entity Type | Organization
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Legal Business Name | PHARAOHS TRADING L.L.C.
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Dates
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Enumeration Date | 05/12/2021
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Last Update Date | 05/12/2021
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Provider Practice Location Address
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Address Line | 743 S NOVA RD
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City | ORMOND BEACH
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State | FL
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Zip | 32174-7332
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Country | US
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Telephone | 386-366-2016
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Fax | 386-238-9845
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Provider Business Mailing Address
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Address Line | 743 S NOVA RD
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City | ORMOND BEACH
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State | FL
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Zip | 32174-7332
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Country | US
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Telephone | 386-366-2016
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. PETER GENDI
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Credential |
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Telephone | 386-366-2016
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BN1400X
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Taxonomy Name | Nursing Facility Supplies (DME)
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License Number |
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License Number State |
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Taxonomy #2
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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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