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Organization
SOUTHEASTERN DME LLC
Active
Organization
SOUTHEASTERN DME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REINALDO WILSON (OWNER)
(336) 740-0899
Entity
Organization
Contact information
Practice address
200 S INDIAN RIVER DR STE 300, FORT PIERCE, FL 34950
(772) 460-6091
Mailing address
29 JACKS CT, RICHMOND HILL, GA 31324-9344
(336) 740-0899
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
NULL
Other
Enumeration date
03/27/2018
Last updated
05/17/2018
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