Provider Demographics
NPI:1689004954
Name:NATIONAL DURABLE MEDICAL EQUIPMENT
Entity Type:Organization
Organization Name:NATIONAL DURABLE MEDICAL EQUIPMENT
Other - Org Name:NATIONAL DME
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:J.
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:COTTIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-644-1968
Mailing Address - Street 1:PO BOX 367
Mailing Address - Street 2:
Mailing Address - City:MIDVALE
Mailing Address - State:UT
Mailing Address - Zip Code:84047-9998
Mailing Address - Country:US
Mailing Address - Phone:800-644-1968
Mailing Address - Fax:801-566-3782
Practice Address - Street 1:1087 NW 53RD ST
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33309-3161
Practice Address - Country:US
Practice Address - Phone:800-644-1968
Practice Address - Fax:801-566-3782
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-22
Last Update Date:2013-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT3904820003Medicare PIN