Provider Demographics
NPI:1598766651
Name:MERIT MEDICAL SERVICES, INC
Entity Type:Organization
Organization Name:MERIT MEDICAL SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFERY
Authorized Official - Middle Name:M
Authorized Official - Last Name:DUNCAN
Authorized Official - Suffix:
Authorized Official - Credentials:RRT
Authorized Official - Phone:386-671-0150
Mailing Address - Street 1:200 TOMOKA AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174-6314
Mailing Address - Country:US
Mailing Address - Phone:386-671-0150
Mailing Address - Fax:386-671-0920
Practice Address - Street 1:200 TOMOKA AVE
Practice Address - Street 2:SUITE A
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-6314
Practice Address - Country:US
Practice Address - Phone:386-671-0150
Practice Address - Fax:386-671-0920
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-10
Last Update Date:2013-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1075332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0443960001Medicare NSC