Provider Demographics
NPI:1922681832
Name:MARCO ISLAND MATTRESS COMPANY LLC
Entity Type:Organization
Organization Name:MARCO ISLAND MATTRESS COMPANY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:G
Authorized Official - Last Name:SUMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-970-4095
Mailing Address - Street 1:713 BALD EAGLE DR
Mailing Address - Street 2:
Mailing Address - City:MARCO ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:34145-2572
Mailing Address - Country:US
Mailing Address - Phone:239-970-4095
Mailing Address - Fax:
Practice Address - Street 1:713 BALD EAGLE DR
Practice Address - Street 2:
Practice Address - City:MARCO ISLAND
Practice Address - State:FL
Practice Address - Zip Code:34145-2572
Practice Address - Country:US
Practice Address - Phone:239-970-4095
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-29
Last Update Date:2021-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies