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General NPI Number Information
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NPI Number | 1609864438
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Entity Type | Organization
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Legal Business Name | MED REPAIRS INC
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Dates
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Enumeration Date | 10/06/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3120 AVIATION BLVD
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City | VERO BEACH
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State | FL
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Zip | 32960
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Country | US
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Telephone | 772-569-2901
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Fax | 772-569-1771
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Provider Business Mailing Address
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Address Line | 3120 AVIATION BLVD
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City | VERO BEACH
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State | FL
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Zip | 32960
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Country | US
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Telephone | 772-569-2901
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Fax | 772-569-1771
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Authorized Official
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Title or Position | PRES
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Name | MR. EARL HENRY YATES
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Credential |
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Telephone | 772-569-2901
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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 | 1382
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License Number State | FL
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