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General NPI Number Information
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NPI Number | 1427215508
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Entity Type | Organization
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Legal Business Name | PRATTVILLE MEDICAL EQUIPMENT INC.
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Dates
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Enumeration Date | 05/17/2008
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Last Update Date | 07/03/2019
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Provider Practice Location Address
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Address Line | 466 E MAIN ST
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City | PRATTVILLE
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State | AL
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Zip | 36067-3420
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Country | US
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Telephone | 334-358-7500
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Fax | 334-358-0555
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Provider Business Mailing Address
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Address Line | 3325 BARTLETT BLVD
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City | ORLANDO
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State | FL
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Zip | 32811-6428
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Country | US
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Telephone | 407-206-0040
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Fax | 407-206-0010
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Authorized Official
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Title or Position | CEO, PRESIDENT
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Name | MR. STEPHEN P GRIGGS
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Credential |
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Telephone | 407-206-0040
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number | 082178
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License Number State | AL
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