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General NPI Number Information
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NPI Number | 1417924341
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Entity Type | Organization
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Legal Business Name | SWEETWATER MEDICAL EAST INC
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Dates
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Enumeration Date | 02/28/2006
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Last Update Date | 05/27/2014
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Provider Practice Location Address
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Address Line | 809 E HIBISCUS BLVD
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City | MELBOURNE
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State | FL
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Zip | 32901-3219
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Country | US
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Telephone | 321-953-2300
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Fax | 321-953-0142
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Provider Business Mailing Address
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Address Line | PO BOX 879
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City | MELBOURNE
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State | FL
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Zip | 32902-0879
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Country | US
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Telephone | 321-953-2300
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Fax | 321-953-0142
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Authorized Official
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Title or Position | SENIOR VICE PRESIDENT
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Name | CATHY BATTREALL
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Credential |
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Telephone | 305-852-7375
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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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