MEDICARE: JIM PREVETT

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	:	1326018011
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JIM PREVETT

Provider Business Mailing Address
First Line	:	129 MANOMET AVE
Second Line	:
City	:	HULL
State	:	MA
Zip	:	02045-2128
Country	:	US
Telephone Number	:	781-925-9493
Fax Number	:	781-925-1203

Provider Business Practice Location Address
First Line	:	129 MANOMET AVE
Second Line	:
City	:	HULL
State	:	MA
Zip	:	02045-2128
Country	:	US
Telephone Number	:	781-925-9493
Fax Number	:	781-925-1203

Authorized Official
Title or Position	:	OWNER
Name	:	JAMES PREVETT
Credential	:
Telephone Number	:	781-925-9493

Provider Enumeration Date	:	01/25/2006
Last Update Date	:	03/24/2008

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