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General NPI Number Information
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NPI Number | 1467821942
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Entity Type | Organization
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Legal Business Name | MEDICAL EQUIPMENT AND SUPPLIES OF AMERICA LLC
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Dates
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Enumeration Date | 09/15/2015
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Last Update Date | 09/15/2015
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Provider Practice Location Address
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Address Line | 7275 S REVERE PKWY SUITE 803
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City | CENTENNIAL
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State | CO
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Zip | 80112-6783
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Country | US
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Telephone | 303-747-5108
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Fax | 866-727-2399
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Provider Business Mailing Address
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Address Line | 11601 56TH CT N
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City | CLEARWATER
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State | FL
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Zip | 33760-4805
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Country | US
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Telephone | 727-851-9880
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Fax | 866-727-2399
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Authorized Official
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Title or Position | CEO
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Name | MR. JEFF CLEVELAND
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Credential |
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Telephone | 727-851-9880
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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 | 20156000258
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License Number State | CO
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