Provider Demographics
NPI:1467457838
Name:MEDI HEALTH CARE INC
Entity Type:Organization
Organization Name:MEDI HEALTH CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:SLAMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:863-686-0300
Mailing Address - Street 1:401 BARTOW RD
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33801-5461
Mailing Address - Country:US
Mailing Address - Phone:863-686-0300
Mailing Address - Fax:
Practice Address - Street 1:401 BARTOW RD
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33801-5461
Practice Address - Country:US
Practice Address - Phone:863-686-0300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-14
Last Update Date:2011-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL964332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1028132OtherUNITED HEALTHCARE
FL227395OtherAMERIGROUP
FLR4465OtherBLUE CROSS/BLUE SHIELD
FL229271100OtherUS DEPARTMENT OF LABOR
FL027182900Medicaid
FLR4465OtherBLUE CROSS/BLUE SHIELD