Provider Demographics
NPI:1659862597
Name:PATRIOT MEDICAL INC
Entity Type:Organization
Organization Name:PATRIOT MEDICAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:NEU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-679-0652
Mailing Address - Street 1:5909 EGRET LANDING PL
Mailing Address - Street 2:
Mailing Address - City:LITHIA
Mailing Address - State:FL
Mailing Address - Zip Code:33547-3964
Mailing Address - Country:US
Mailing Address - Phone:813-679-0652
Mailing Address - Fax:844-349-5531
Practice Address - Street 1:5909 EGRET LANDING PL
Practice Address - Street 2:
Practice Address - City:LITHIA
Practice Address - State:FL
Practice Address - Zip Code:33547-3964
Practice Address - Country:US
Practice Address - Phone:813-679-0652
Practice Address - Fax:844-349-5531
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-27
Last Update Date:2018-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies