Provider Demographics
NPI:1093278335
Name:MATTRESS DIRECT OF VOLUSIA LLC
Entity Type:Organization
Organization Name:MATTRESS DIRECT OF VOLUSIA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:ZIRBEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:386-848-0442
Mailing Address - Street 1:1720 S WOODLAND BLVD
Mailing Address - Street 2:
Mailing Address - City:DELAND
Mailing Address - State:FL
Mailing Address - Zip Code:32720-7915
Mailing Address - Country:US
Mailing Address - Phone:386-848-0442
Mailing Address - Fax:
Practice Address - Street 1:1720 S WOODLAND BLVD
Practice Address - Street 2:
Practice Address - City:DELAND
Practice Address - State:FL
Practice Address - Zip Code:32720-7915
Practice Address - Country:US
Practice Address - Phone:386-848-0442
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-12
Last Update Date:2019-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies