Provider Demographics
NPI:1457438715
Name:R & L MEDICAL ENTERPRISES INC
Entity type:Organization
Organization Name:R & L MEDICAL ENTERPRISES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:MACCLELLAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-448-5757
Mailing Address - Street 1:8535 BAYMEADOWS RD
Mailing Address - Street 2:SUITE14
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-7448
Mailing Address - Country:US
Mailing Address - Phone:904-448-5757
Mailing Address - Fax:904-448-9797
Practice Address - Street 1:8535 BAYMEADOWS RD
Practice Address - Street 2:SUITE 14
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-7448
Practice Address - Country:US
Practice Address - Phone:904-448-5757
Practice Address - Fax:904-448-9797
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2007-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1312517332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL5453430001Medicare ID - Type UnspecifiedDURABLE MEDICAL EQUIPMENT