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General NPI Number Information
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NPI Number | 1760593495
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Entity Type | Organization
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Legal Business Name | SOUTHERN HEALTHCARE SERVICES, LLC
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 11/26/2008
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Provider Practice Location Address
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Address Line | 1445 N CONGRESS AVE SUITE 11 & 12
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City | DELRAY BEACH
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State | FL
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Zip | 33445-6380
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Country | US
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Telephone | 561-265-4271
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Fax | 561-423-0819
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Provider Business Mailing Address
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Address Line | PO BOX 2124
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City | ASBURY PARK
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State | NJ
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Zip | 07712-2124
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Country | US
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Telephone | 732-531-6875
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Fax | 732-531-3593
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Authorized Official
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Title or Position | PRESIDENT, OPERATIONS
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Name | MICHAEL BOBRICK
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Credential |
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Telephone | 561-265-4271
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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 | 1313044
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License Number State | FL
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