Provider Demographics
NPI:1679080063
Name:ACTIVE ASSIST DME, INC.
Entity Type:Organization
Organization Name:ACTIVE ASSIST DME, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ZUSMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-389-9040
Mailing Address - Street 1:14004 ROOSEVELT BLVD STE 607
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33762-3819
Mailing Address - Country:US
Mailing Address - Phone:727-351-7949
Mailing Address - Fax:
Practice Address - Street 1:14004 ROOSEVELT BLVD STE 607
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33762-3819
Practice Address - Country:US
Practice Address - Phone:727-351-7949
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-07
Last Update Date:2018-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies