Organization
PRIMECARE DME SUPPLY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DALE A WALLACE (PRESIDENT)
(407) 585-0393
Entity
Organization
Contact information
Practice address
333 GORDON ST, SUITE A, SANFORD, FL 32771-6325
(407) 585-0393
(407) 585-0396
Mailing address
333 GORDON ST, SUITE A, SANFORD, FL 32771-6325
(407) 585-0393
(407) 585-0396
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
10/04/2005
Last updated
08/22/2020
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