Provider Demographics
NPI:1215566047
Name:CWB MEDICAL SOLUTIONS LLC
Entity Type:Organization
Organization Name:CWB MEDICAL SOLUTIONS LLC
Other - Org Name:MERAKI MEDICAL SOLUTIONS LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MITCHELL
Authorized Official - Middle Name:
Authorized Official - Last Name:PANTELIDES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-316-5485
Mailing Address - Street 1:3233 E BAY DR STE 107
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33771-1900
Mailing Address - Country:US
Mailing Address - Phone:727-316-5485
Mailing Address - Fax:727-754-5575
Practice Address - Street 1:3233 E BAY DR STE 107
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33771-1900
Practice Address - Country:US
Practice Address - Phone:727-316-5485
Practice Address - Fax:727-754-5575
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-03
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL114587500Medicaid