Provider Demographics
NPI:1144663444
Name:FLORIDA HOME MEDICAL SUPPLY INC.
Entity type:Organization
Organization Name:FLORIDA HOME MEDICAL SUPPLY INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:BRUINSMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-849-6455
Mailing Address - Street 1:614 E ALTAMONTE DR
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32701-4803
Mailing Address - Country:US
Mailing Address - Phone:407-849-6455
Mailing Address - Fax:407-849-6458
Practice Address - Street 1:5100 POPLAR AVE
Practice Address - Street 2:SUITE 2700
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38137-4000
Practice Address - Country:US
Practice Address - Phone:800-747-0246
Practice Address - Fax:800-487-7163
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-17
Last Update Date:2013-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1313277332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies