MEDICARE: MEDI HEALTH CARE 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	964	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1028132	OTHER	FL	UNITED HEALTHCARE
2	227395	OTHER	FL	AMERIGROUP
3	R4465	OTHER	FL	BLUE CROSS/BLUE SHIELD
4	229271100	OTHER	FL	US DEPARTMENT OF LABOR
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1467457838
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDI HEALTH CARE INC

Provider Business Mailing Address
First Line	:	401 BARTOW RD
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33801-5461
Country	:	US
Telephone Number	:	863-686-0300
Fax Number	:

Provider Business Practice Location Address
First Line	:	401 BARTOW RD
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33801-5461
Country	:	US
Telephone Number	:	863-686-0300
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. ROBERT SLAMA
Credential	:
Telephone Number	:	863-686-0300

Provider Enumeration Date	:	06/14/2005
Last Update Date	:	05/17/2011

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