Provider Demographics
NPI:1710469861
Name:TWILIGHT MEDICAL, INC.
Entity Type:Organization
Organization Name:TWILIGHT MEDICAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:WOLFE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-935-1365
Mailing Address - Street 1:905 E MARTIN LUTHER KING JR DR STE 280
Mailing Address - Street 2:
Mailing Address - City:TARPON SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34689-4810
Mailing Address - Country:US
Mailing Address - Phone:727-935-1365
Mailing Address - Fax:
Practice Address - Street 1:905 E MARTIN LUTHER KING JR DR STE 280
Practice Address - Street 2:
Practice Address - City:TARPON SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34689-4810
Practice Address - Country:US
Practice Address - Phone:727-935-1365
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-05
Last Update Date:2018-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies