MEDICARE: PREMIER MEDICAL EQUIPMENT, 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

General Provider Information

NPI Number	:	1083087894
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PREMIER MEDICAL EQUIPMENT, INC

Provider Business Mailing Address
First Line	:	8403 BENJAMIN RD
Second Line	:	SUITE A
City	:	TAMPA
State	:	FL
Zip	:	33634-1204
Country	:	US
Telephone Number	:	813-903-2382
Fax Number	:	813-425-7759

Provider Business Practice Location Address
First Line	:	8403 BENJAMIN RD
Second Line	:	SUITE A
City	:	TAMPA
State	:	FL
Zip	:	33634-1204
Country	:	US
Telephone Number	:	813-903-2382
Fax Number	:	813-425-7759

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. CHRISTOPHER SHANE MILLER
Credential	:
Telephone Number	:	813-903-2382

Provider Enumeration Date	:	11/03/2015
Last Update Date	:	11/03/2015

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