Provider Demographics
NPI:1346266632
Name:DECUBEX INC
Entity Type:Organization
Organization Name:DECUBEX INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MGR
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATTY
Authorized Official - Middle Name:D
Authorized Official - Last Name:LONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:386-698-3737
Mailing Address - Street 1:1025 BLANDING BLVD
Mailing Address - Street 2:SUITE 503
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32065-7750
Mailing Address - Country:US
Mailing Address - Phone:904-213-0426
Mailing Address - Fax:904-213-1086
Practice Address - Street 1:1025 BLANDING BLVD
Practice Address - Street 2:SUITE 503
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32065-7750
Practice Address - Country:US
Practice Address - Phone:904-213-0426
Practice Address - Fax:904-213-1086
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-13
Last Update Date:2009-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1022332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLR8679OtherBCBS PROVIDER #
FL=========OtherTRICARE PROVIDER #
FL=========OtherTRICARE PROVIDER #