Provider Demographics
NPI:1932325222
Name:EDARCH MEDICAL INC.
Entity Type:Organization
Organization Name:EDARCH MEDICAL INC.
Other - Org Name:MEDSTAR MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-626-1333
Mailing Address - Street 1:3801 CORPOREX PARK DR
Mailing Address - Street 2:STE. 175
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33619-1183
Mailing Address - Country:US
Mailing Address - Phone:813-626-1333
Mailing Address - Fax:813-622-6662
Practice Address - Street 1:3801 CORPOREX PARK DR
Practice Address - Street 2:STE. 175
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33619-1183
Practice Address - Country:US
Practice Address - Phone:813-626-1333
Practice Address - Fax:813-622-6662
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1312356332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLR8267OtherDME PROVIDER
FL4746140001Medicare NSC