MEDICARE: CREWS-ING CHAIR COMPANY, LLC

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	332BC3200X	Customized Equipment (DME)

General Provider Information

NPI Number	:	1518169150
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CREWS-ING CHAIR COMPANY, LLC

Provider Business Mailing Address
First Line	:	21524 WEBBWOOD AVE
Second Line	:
City	:	PORT CHARLOTTE
State	:	FL
Zip	:	33954-3856
Country	:	US
Telephone Number	:	941-627-1900
Fax Number	:	941-627-0054

Provider Business Practice Location Address
First Line	:	21524 WEBBWOOD AVE
Second Line	:
City	:	PORT CHARLOTTE
State	:	FL
Zip	:	33954-3856
Country	:	US
Telephone Number	:	941-627-1900
Fax Number	:	941-627-0054

Authorized Official
Title or Position	:	GENERAL PARTNER
Name	:	MR. STANLEY R CREWS
Credential	:
Telephone Number	:	941-627-1900

Provider Enumeration Date	:	06/05/2007
Last Update Date	:	08/22/2020

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