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General NPI Number Information
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NPI Number | 1952310963
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Entity Type | Organization
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Legal Business Name | BOGER ENTERPRISES INC
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Dates
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Enumeration Date | 08/07/2006
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Last Update Date | 12/21/2023
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Provider Practice Location Address
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Address Line | 845 BLANDING BLVD
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City | ORANGE PARK
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State | FL
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Zip | 32065-8947
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Country | US
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Telephone | 904-356-0459
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Fax |
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Provider Business Mailing Address
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Address Line | 845 BLANDING BLVD
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City | ORANGE PARK
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State | FL
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Zip | 32065-8947
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Country | US
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Telephone | 904-356-0459
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. BRETT W BOGER
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Credential | CPED
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Telephone | 904-356-0459
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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 | PED179
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License Number State | FL
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