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General NPI Number Information
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NPI Number | 1902070626
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Entity Type | Organization
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Legal Business Name | CPS MEDICAL EQUIPMENT AND SUPPLY
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Dates
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Enumeration Date | 04/14/2008
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Last Update Date | 08/26/2009
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Provider Practice Location Address
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Address Line | 18908 REHOBOTH MALL BLVD
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City | REHOBOTH BEACH
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State | DE
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Zip | 19971-6134
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Country | US
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Telephone | 302-226-3311
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Fax | 302-226-3011
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Provider Business Mailing Address
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Address Line | PO BOX 249
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City | REHOBOTH BEACH
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State | DE
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Zip | 19971-6134
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Country | US
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Telephone | 302-226-3311
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Fax | 302-226-3011
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Authorized Official
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Title or Position | PARTNER/OWNER
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Name | MR. ANDREW LEE HERRICK
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Credential |
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Telephone | 302-226-3311
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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 | 2001104236
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License Number State | DE
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