Provider Demographics
NPI:1740478940
Name:PROFESSIONAL HEALTH EXAMINERS
Entity type:Organization
Organization Name:PROFESSIONAL HEALTH EXAMINERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:VIVIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KRUMEL
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:850-434-6168
Mailing Address - Street 1:3298 SUMMIT BLVD STE 33
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32503-8318
Mailing Address - Country:US
Mailing Address - Phone:850-434-6168
Mailing Address - Fax:850-434-3145
Practice Address - Street 1:3298 SUMMIT BLVD STE 33
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32503-8318
Practice Address - Country:US
Practice Address - Phone:850-434-6168
Practice Address - Fax:850-434-3145
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-12
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLJ02524332900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site