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General NPI Number Information
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NPI Number | 1891026324
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Entity Type | Organization
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Legal Business Name | PROFOUND MEDICAL EQUIPMENT, INC.
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Dates
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Enumeration Date | 01/22/2010
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Last Update Date | 01/22/2010
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Provider Practice Location Address
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Address Line | 6343 S CHICKASAW TRL
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City | ORLANDO
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State | FL
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Zip | 32829-8369
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Country | US
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Telephone | 877-710-8181
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Fax | 407-249-5701
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Provider Business Mailing Address
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Address Line | PO BOX 691724
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City | ORLANDO
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State | FL
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Zip | 32869-1724
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Country | US
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Telephone | 877-710-8181
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Fax | 407-249-5701
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Authorized Official
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Title or Position | SOLE OWNER
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Name | MS. TERRI MARIE VANIWARDEN
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Credential |
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Telephone | 877-710-8181
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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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