MEDICARE: NATIONWIDE MEDICAL HOSPITALITY SERVICES INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies	608	FL

General Provider Information

NPI Number	:	1033119565
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NATIONWIDE MEDICAL HOSPITALITY SERVICES INC

Provider Business Mailing Address
First Line	:	2018 S RIDGEWOOD AVE
Second Line	:
City	:	EDGEWATER
State	:	FL
Zip	:	32141-4207
Country	:	US
Telephone Number	:	386-427-6482
Fax Number	:	386-427-6870

Provider Business Practice Location Address
First Line	:	2018 S RIDGEWOOD AVE
Second Line	:
City	:	EDGEWATER
State	:	FL
Zip	:	32141-4207
Country	:	US
Telephone Number	:	386-427-6482
Fax Number	:	386-427-6870

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. GEORGE H MUNDELL JR.
Credential	:
Telephone Number	:	386-427-6482

Provider Enumeration Date	:	07/27/2005
Last Update Date	:	08/22/2020

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