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Organization
SUPERMED INC
Active
Organization
SUPERMED INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHILLIP BANE (PRESIDENT)
(540) 397-4318
Entity
Organization
Contact information
Practice address
525 SHADOW LAKES BLVD, ORMOND BEACH, FL 32174-5003
(386) 672-9530
(386) 677-2072
Mailing address
525 SHADOW LAKES BLVD, ORMOND BEACH, FL 32174-5003
(386) 672-9530
(386) 677-2072
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
HME868
FL
332BX2000X
Oxygen Equipment & Supplies (DME)
HME868
FL
Other
Enumeration date
08/10/2005
Last updated
02/12/2014
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