Provider Demographics
NPI:1366429805
Name:MEDPEND, INC.
Entity type:Organization
Organization Name:MEDPEND, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:PENDRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-688-1868
Mailing Address - Street 1:222 HICKMAN DR
Mailing Address - Street 2:# 102
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32771-6917
Mailing Address - Country:US
Mailing Address - Phone:407-688-1868
Mailing Address - Fax:407-688-7732
Practice Address - Street 1:222 HICKMAN DR
Practice Address - Street 2:# 102
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32771-6917
Practice Address - Country:US
Practice Address - Phone:407-688-1868
Practice Address - Fax:407-688-7732
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1123332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1123OtherSTATE DME LICENSE NUMBER
FL1253780002Medicare ID - Type UnspecifiedMEDICARE NUMBER