MEDICARE: HUNTLEIGH HEALTHCARE 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	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1689854036
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HUNTLEIGH HEALTHCARE LLC

Provider Business Mailing Address
First Line	:	40 CHRISTOPHER WAY
Second Line	:
City	:	EATONTOWN
State	:	NJ
Zip	:	07724-3327
Country	:	US
Telephone Number	:	800-223-1218
Fax Number	:	732-676-1096

Provider Business Practice Location Address
First Line	:	4521-6 SAINT AUGUSTINE RD
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32207-9532
Country	:	US
Telephone Number	:	904-306-9960
Fax Number	:	904-306-9940

Authorized Official
Title or Position	:	PRES/CEO
Name	:	MR. ROBERT S ANGEL
Credential	:
Telephone Number	:	800-223-1218

Provider Enumeration Date	:	11/13/2007
Last Update Date	:	11/13/2007

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