=====================================================
General NPI Number Information
=====================================================
NPI Number | 1881695906
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PRESCOTT MEDICAL EQUIPMENT, INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/10/2005
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2250 ALOMA AVE
-----------------------------------------------------
City | WINTER PARK
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32792-3304
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-628-1357
-----------------------------------------------------
Fax | 407-740-6348
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2250 ALOMA AVE
-----------------------------------------------------
City | WINTER PARK
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32792-3304
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-628-1357
-----------------------------------------------------
Fax | 407-740-6348
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRES./OWNER
-----------------------------------------------------
Name | MR. PERMANAND SAM BHIKHA
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 407-628-1357
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332B00000X
-----------------------------------------------------
Taxonomy Name | Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
License Number | 1253
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------