Provider Demographics
NPI:1689800989
Name:PROFESSIONAL PRODUCTS INC
Entity Type:Organization
Organization Name:PROFESSIONAL PRODUCTS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:STANTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-274-9005
Mailing Address - Street 1:54 HUGH ADAMS RD
Mailing Address - Street 2:
Mailing Address - City:DEFUNIAK SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32435-3400
Mailing Address - Country:US
Mailing Address - Phone:800-274-9005
Mailing Address - Fax:800-274-9006
Practice Address - Street 1:54 HUGH ADAMS RD
Practice Address - Street 2:
Practice Address - City:DEFUNIAK SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32435-3400
Practice Address - Country:US
Practice Address - Phone:800-274-9005
Practice Address - Fax:800-274-9006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-02
Last Update Date:2009-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies