MEDICARE: AEROCARE HOME 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
2	332BX2000X	Oxygen Equipment & Supplies (DME)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	179107	OTHER		BLUE CROSS BLUE SHIELD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174563563
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AEROCARE HOME MEDICAL EQUIPMENT, INC.

Provider Business Mailing Address
First Line	:	3325 BARTLETT BLVD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32811-6428
Country	:	US
Telephone Number	:	407-206-0040
Fax Number	:	407-206-0010

Provider Business Practice Location Address
First Line	:	329 N BARRETT LN
Second Line	:	SUITE A
City	:	NEVADA
State	:	MO
Zip	:	64772
Country	:	US
Telephone Number	:	417-667-6224
Fax Number	:	417-667-6324

Authorized Official
Title or Position	:	CEO
Name	:	MR. STEPHEN P GRIGGS
Credential	:
Telephone Number	:	407-206-0040

Provider Enumeration Date	:	06/07/2006
Last Update Date	:	07/24/2018

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