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Organization
LONGS HOME MED SRVC AND EQUIP INC.
Active
Organization
LONGS HOME MED SRVC AND EQUIP INC.
Active
Other names
Long's Home Medical
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DOTTIE CULLEN (CEO)
(352) 735-1120
Entity
Organization
Contact information
Practice address
3801 N HIGHWAY 19A, STE 408, MOUNT DORA, FL 32757-2228
(352) 735-1120
(352) 735-1137
Mailing address
3801 N HIGHWAY 19A, STE 408, MOUNT DORA, FL 32757-2228
(352) 735-1120
(352) 735-1137
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
1312180
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
026896800
—
FL
01
—
R5491
BCBS FEDERAL PROVIEDER ID
FL
Enumeration date
10/06/2006
Last updated
06/02/2011
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