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General NPI Number Information
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NPI Number | 1497939268
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Entity Type | Organization
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Legal Business Name | DECUBEX INCORPORATED
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Dates
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Enumeration Date | 12/28/2007
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Last Update Date | 12/28/2007
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Provider Practice Location Address
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Address Line | 1025 BLANDING BLVD UNIT 503
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City | ORANGE PARK
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State | FL
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Zip | 32065-7750
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Country | US
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Telephone | 904-213-0426
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Fax | 904-276-2733
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Provider Business Mailing Address
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Address Line | 2717 N W ST UNIT A
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City | PENSACOLA
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State | FL
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Zip | 32505-8400
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Country | US
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Telephone | 850-429-0383
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Fax | 850-429-0367
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Authorized Official
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Title or Position | PRESIDENT
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Name | EDWARD SHANCEY III
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Credential |
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Telephone | 904-213-0426
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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 | 1022
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License Number State | FL
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