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General NPI Number Information
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NPI Number | 1841225182
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Entity Type | Organization
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Legal Business Name | CERTIFIED MEDICAL SYSTEMS I, INC
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Dates
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Enumeration Date | 07/12/2006
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Last Update Date | 05/09/2012
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Provider Practice Location Address
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Address Line | 2141 LOCH RANE BLVD SUITE 116
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City | ORANGE PARK
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State | FL
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Zip | 32073-5723
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Country | US
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Telephone | 904-272-3022
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Fax |
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Provider Business Mailing Address
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Address Line | 2141 LOCH RANE BLVD SUITE 116
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City | ORANGE PARK
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State | FL
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Zip | 32073-5723
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Country | US
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Telephone | 904-272-3022
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Fax |
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Authorized Official
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Title or Position | VICE-PRESIDENT
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Name | MR. MICHAEL DILLMAN
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Credential |
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Telephone | 904-272-3022
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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 | 20-8012346099-6
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License Number State | FL
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