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General NPI Number Information
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NPI Number | 1609984970
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Entity Type | Organization
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Legal Business Name | PRO HOME MEDICAL EQUIPMENT, INC.
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Dates
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Enumeration Date | 08/28/2006
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Last Update Date | 04/28/2008
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Provider Practice Location Address
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Address Line | 2187 SIESTA DRIVE
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City | SARASOTA
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State | FL
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Zip | 34239
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Country | US
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Telephone | 941-365-1499
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Fax | 941-365-3929
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Provider Business Mailing Address
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Address Line | 2187 SIESTA DR
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City | SARASOTA
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State | FL
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Zip | 34239-5235
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Country | US
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Telephone | 941-365-1499
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Fax | 941-365-3929
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Authorized Official
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Title or Position | OWNER
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Name | MR. TRAVIS PATRICK RODGERS JR.
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Credential |
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Telephone | 941-365-1499
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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 | 911
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License Number State | FL
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