# FIRST COAST MEDICAL & DENTAL SUPPLY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083442826
- **Authorized official:** MR. LADD NICHOLS (MANAGER)
- **Authorized official phone:** (904) 881-1804

## Contact information

- **Practice address:** 140 N ONE DR STE B, ST AUGUSTINE, FL 32095-8372
- **Practice address phone:** (904) 460-2549
- **Practice address fax:** (904) 814-8380
- **Mailing address:** 140 N ONE DR STE B, ST AUGUSTINE, FL 32095-8372
- **Mailing address phone:** (904) 460-2549
- **Mailing address fax:** (904) 814-8380

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | Yes |

## Other

- **Enumeration date:** 07/23/2024
- **Last updated:** 07/23/2024