Provider Demographics
NPI:1477662070
Name:THOMAS ENTERPRIZES
Entity Type:Organization
Organization Name:THOMAS ENTERPRIZES
Other - Org Name:FOOT SOLUTIONS-BEACHES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JIMMIE
Authorized Official - Middle Name:B
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-247-0460
Mailing Address - Street 1:4126 3RD ST S
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32250-5833
Mailing Address - Country:US
Mailing Address - Phone:904-247-0460
Mailing Address - Fax:904-247-0490
Practice Address - Street 1:4126 3RD ST S
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE BEACH
Practice Address - State:FL
Practice Address - Zip Code:32250-5833
Practice Address - Country:US
Practice Address - Phone:904-247-0460
Practice Address - Fax:904-247-0490
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-29
Last Update Date:2008-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL5379460001Medicare NSC