Provider Demographics
NPI:1699397117
Name:WESLEY CHAPEL DME LLC
Entity Type:Organization
Organization Name:WESLEY CHAPEL DME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:KIRSCHNER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:813-907-9553
Mailing Address - Street 1:PO BOX 7382
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33545-0106
Mailing Address - Country:US
Mailing Address - Phone:813-907-9553
Mailing Address - Fax:813-907-9554
Practice Address - Street 1:5808 BOYETTE RD
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33545-4122
Practice Address - Country:US
Practice Address - Phone:813-907-9553
Practice Address - Fax:813-907-9554
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-07
Last Update Date:2020-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service