MEDICARE: NATIONAL DURABLE MEDICAL EQUIPMENT

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	:	1689004954
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NATIONAL DURABLE MEDICAL EQUIPMENT

Provider Business Mailing Address
First Line	:	PO BOX 367
Second Line	:
City	:	MIDVALE
State	:	UT
Zip	:	84047-9998
Country	:	US
Telephone Number	:	800-644-1968
Fax Number	:	801-566-3782

Provider Business Practice Location Address
First Line	:	1087 NW 53RD ST
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33309-3161
Country	:	US
Telephone Number	:	800-644-1968
Fax Number	:	801-566-3782

Authorized Official
Title or Position	:	CEO
Name	:	J. SCOTT COTTIS
Credential	:
Telephone Number	:	800-644-1968

Provider Enumeration Date	:	11/22/2013
Last Update Date	:	11/22/2013

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