Provider Demographics
NPI:1932132701
Name:PATRIOT MEDICAL, INC.
Entity Type:Organization
Organization Name:PATRIOT MEDICAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:S
Authorized Official - Last Name:LEGATH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-347-2568
Mailing Address - Street 1:310 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SAFETY HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34695-3645
Mailing Address - Country:US
Mailing Address - Phone:727-712-1928
Mailing Address - Fax:
Practice Address - Street 1:310 MAIN ST
Practice Address - Street 2:
Practice Address - City:SAFETY HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34695-3645
Practice Address - Country:US
Practice Address - Phone:727-712-1928
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-07
Last Update Date:2009-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL108212001Medicare ID - Type Unspecified
FL1082120001Medicare NSC