Provider Demographics
NPI:1457677916
Name:SPRINGSMED LLC
Entity Type:Organization
Organization Name:SPRINGSMED LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:HELI
Authorized Official - Middle Name:A
Authorized Official - Last Name:SHULTZ
Authorized Official - Suffix:
Authorized Official - Credentials:JD
Authorized Official - Phone:239-908-2776
Mailing Address - Street 1:PO BOX 1258
Mailing Address - Street 2:
Mailing Address - City:BONITA SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34133-1258
Mailing Address - Country:US
Mailing Address - Phone:239-908-2776
Mailing Address - Fax:866-587-6694
Practice Address - Street 1:9114 BONITA BEACH RD SE
Practice Address - Street 2:
Practice Address - City:BONITA SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34135-4207
Practice Address - Country:US
Practice Address - Phone:239-908-2776
Practice Address - Fax:866-587-6694
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-08
Last Update Date:2013-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL6439140001Medicare NSC