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Organization
MEDICAL DEPARTMENT STORE AND DISCOUNT UNIFORMS, INC.
Active
Organization
MEDICAL DEPARTMENT STORE AND DISCOUNT UNIFORMS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN OCASIO (PRESIDENT)
(239) 274-0304
Entity
Organization
Contact information
Practice address
8595 COLLEGE PKWY, FORT MYERS, FL 33919-5191
(239) 482-6111
(239) 482-6178
Mailing address
PO BOX 07100, FORT MYERS, FL 33919-0100
(239) 274-0304
(239) 274-0307
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
800017
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R9258
BLUE CROSS BLUE SHIELD
FL
Enumeration date
09/20/2006
Last updated
08/22/2020
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