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General NPI Number Information
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NPI Number | 1831722909
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Entity Type | Organization
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Legal Business Name | MEDICAL EQUIPMENT AND SUPPLIES OF AMERICA LLC
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Dates
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Enumeration Date | 02/18/2020
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Last Update Date | 02/18/2020
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Provider Practice Location Address
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Address Line | 1614 NW 55TH PL
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City | GAINESVILLE
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State | FL
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Zip | 32653-2109
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Country | US
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Telephone | 855-331-6372
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Fax | 866-727-2399
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Provider Business Mailing Address
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Address Line | 12035 34TH ST N STE 1
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City | ST PETERSBURG
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State | FL
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Zip | 33716-1839
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Country | US
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Telephone | 727-265-7556
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Fax | 866-727-2399
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Authorized Official
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Title or Position | GENERAL MANAGER
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Name | SAMUEL ERIC GELLERSTEDT
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Credential |
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Telephone | 727-851-9880
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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 |
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License Number State |
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