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General NPI Number Information
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NPI Number | 1689983397
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Entity Type | Organization
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Legal Business Name | MENRX SURGICAL, LLC
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Dates
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Enumeration Date | 09/29/2010
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Last Update Date | 06/10/2012
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Provider Practice Location Address
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Address Line | 10302 DEERWOOD PARK BLVD SUITE 209
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City | JACKSONVILLE
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State | FL
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Zip | 32256-2880
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Country | US
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Telephone | 888-881-5486
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Fax | 888-777-6903
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Provider Business Mailing Address
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Address Line | PO BOX 3031
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City | TITUSVILLE
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State | FL
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Zip | 32781-3031
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Country | US
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Telephone | 407-679-2522
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Fax | 407-679-2922
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Authorized Official
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Title or Position | SALES CONSULTANT / ASSOCIATE
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Name | AMBER BOOTH
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Credential |
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Telephone | 888-881-5468
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State |
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