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General NPI Number Information
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NPI Number | 1982908497
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Entity Type | Organization
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Legal Business Name | DURA-MED SOUTHEAST INC.
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Dates
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Enumeration Date | 12/28/2010
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Last Update Date | 12/28/2010
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Provider Practice Location Address
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Address Line | 3877 HWY 4
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City | JAY
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State | FL
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Zip | 32565
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Country | US
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Telephone | 850-675-6850
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Fax | 850-675-6805
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Provider Business Mailing Address
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Address Line | PO BOX 640
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City | JAY
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State | FL
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Zip | 32565-0640
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Country | US
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Telephone | 850-675-6850
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Fax | 850-675-6805
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Authorized Official
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Title or Position | SUPERVISING PHARMACIST
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Name | MISTY HERRING
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Credential |
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Telephone | 850-675-6850
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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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