Provider Demographics
NPI:1457458481
Name:PINELLAS HOME MEDICAL
Entity Type:Organization
Organization Name:PINELLAS HOME MEDICAL
Other - Org Name:PINEVIEW HOME MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:J
Authorized Official - Last Name:SHRIMPTON
Authorized Official - Suffix:
Authorized Official - Credentials:CRTT
Authorized Official - Phone:1800-764-6260
Mailing Address - Street 1:810 53RD AVE W
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34207-3423
Mailing Address - Country:US
Mailing Address - Phone:800-764-6260
Mailing Address - Fax:941-750-8277
Practice Address - Street 1:810 53RD AVE W
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34207-3423
Practice Address - Country:US
Practice Address - Phone:800-764-6260
Practice Address - Fax:941-750-8277
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1630332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0713210001Medicare ID - Type Unspecified