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General NPI Number Information
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NPI Number | 1699598557
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Entity Type | Organization
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Legal Business Name | NEONZ MEDICAL SUPPLIES LLC
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Dates
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Enumeration Date | 11/07/2024
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Last Update Date | 11/07/2024
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Provider Practice Location Address
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Address Line | 151 WINCHESTER TRL
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City | GOSHEN
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State | IN
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Zip | 46526-6164
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Country | US
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Telephone | 352-320-3888
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Fax |
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Provider Business Mailing Address
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Address Line | 151 WINCHESTER TRL
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City | GOSHEN
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State | IN
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Zip | 46526-6164
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Country | US
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Telephone | 352-320-3888
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | NIDA NAZIR
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Credential | OWNER
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Telephone | 352-320-3888
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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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