Provider Demographics
NPI:1033119565
Name:NATIONWIDE MEDICAL HOSPITALITY SERVICES INC
Entity Type:Organization
Organization Name:NATIONWIDE MEDICAL HOSPITALITY SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:H
Authorized Official - Last Name:MUNDELL
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:386-427-6482
Mailing Address - Street 1:2018 S RIDGEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:EDGEWATER
Mailing Address - State:FL
Mailing Address - Zip Code:32141-4207
Mailing Address - Country:US
Mailing Address - Phone:386-427-6482
Mailing Address - Fax:386-427-6870
Practice Address - Street 1:2018 S RIDGEWOOD AVE
Practice Address - Street 2:
Practice Address - City:EDGEWATER
Practice Address - State:FL
Practice Address - Zip Code:32141-4207
Practice Address - Country:US
Practice Address - Phone:386-427-6482
Practice Address - Fax:386-427-6870
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL608332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0561060001Medicare ID - Type Unspecified