Provider Demographics
NPI:1194042143
Name:DAVIE MEDICAL EQUIPMENT, INC.
Entity Type:Organization
Organization Name:DAVIE MEDICAL EQUIPMENT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:VETTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-751-4288
Mailing Address - Street 1:2178 ANDREA LN
Mailing Address - Street 2:UNIT 5
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33912-1986
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2178 ANDREA LN
Practice Address - Street 2:UNIT 5
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33912-1986
Practice Address - Country:US
Practice Address - Phone:336-462-3925
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-30
Last Update Date:2010-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies