Provider Demographics
NPI:1689983397
Name:MENRX SURGICAL, LLC
Entity Type:Organization
Organization Name:MENRX SURGICAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SALES CONSULTANT / ASSOCIATE
Authorized Official - Prefix:
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:
Authorized Official - Last Name:BOOTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-881-5468
Mailing Address - Street 1:PO BOX 3031
Mailing Address - Street 2:
Mailing Address - City:TITUSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32781-3031
Mailing Address - Country:US
Mailing Address - Phone:407-679-2522
Mailing Address - Fax:407-679-2922
Practice Address - Street 1:10302 DEERWOOD PARK BLVD
Practice Address - Street 2:SUITE 209
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-2880
Practice Address - Country:US
Practice Address - Phone:888-881-5486
Practice Address - Fax:888-777-6903
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-29
Last Update Date:2012-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment