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General NPI Number Information
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NPI Number | 1780139741
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Entity Type | Organization
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Legal Business Name | FLETCHER'S MEDICAL SUPPLIES, INC.
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Dates
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Enumeration Date | 08/19/2016
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Last Update Date | 09/29/2016
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Provider Practice Location Address
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Address Line | 641 W 4TH ST
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City | JACKSONVILLE
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State | FL
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Zip | 32209-6624
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Country | US
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Telephone | 904-387-4481
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Fax | 866-381-7235
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Provider Business Mailing Address
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Address Line | 6851 DISTRIBUTION AVE S
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City | JACKSONVILLE
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State | FL
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Zip | 32256-2742
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Country | US
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Telephone | 904-387-4481
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Fax | 866-381-7235
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | MR. WILLIAM DAVID FLETCHER
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Credential |
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Telephone | 904-387-4481
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3140N1450X
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Taxonomy Name | Pediatric Skilled Nursing Facility
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License Number |
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License Number State |
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