MEDICARE: CONRAD MARKETING, 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	:	1730432246
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CONRAD MARKETING, LLC

Provider Business Mailing Address
First Line	:	5022 SAVANNAH RIVER WAY APT 213
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32839-5076
Country	:	US
Telephone Number	:	517-817-6366
Fax Number	:

Provider Business Practice Location Address
First Line	:	5022 SAVANNAH RIVER WAY APT 213
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32839-5076
Country	:	US
Telephone Number	:	517-817-6366
Fax Number	:

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	MRS. BRIDGET COLLEEN CONRAD
Credential	:
Telephone Number	:	517-817-6366

Provider Enumeration Date	:	10/22/2012
Last Update Date	:	10/22/2012

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