Provider Demographics
NPI:1265482434
Name:CULPEPPER HARRELL, INC
Entity Type:Organization
Organization Name:CULPEPPER HARRELL, INC
Other - Org Name:YOUR HOME MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WARREN
Authorized Official - Middle Name:
Authorized Official - Last Name:FLETCHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:386-698-3737
Mailing Address - Street 1:120 N 9TH ST
Mailing Address - Street 2:
Mailing Address - City:PALATKA
Mailing Address - State:FL
Mailing Address - Zip Code:32177-3635
Mailing Address - Country:US
Mailing Address - Phone:386-325-2096
Mailing Address - Fax:386-328-0404
Practice Address - Street 1:120 N 9TH ST
Practice Address - Street 2:
Practice Address - City:PALATKA
Practice Address - State:FL
Practice Address - Zip Code:32177-3635
Practice Address - Country:US
Practice Address - Phone:386-325-2096
Practice Address - Fax:386-328-0404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-10
Last Update Date:2016-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL04643332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLR9977OtherBCBSFL
FL031636900Medicaid
FL0132330003Medicare NSC