Organization
THE MEDICINE CHEST INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DONALD E BERISFORD (OWNER)
(352) 753-1877
Entity
Organization
Contact information
Practice address
910 OLD CAMP RD, BUILDING #170, THE VILLAGES, FL 32162-5604
(352) 753-1877
(352) 753-3755
Mailing address
910 OLD CAMP RD, BUILDING #170, THE VILLAGES, FL 32162-5604
(352) 753-1877
(352) 753-3755
Taxonomy
Speciality
Code
Description
License number
State
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
Primary
PH 0016588
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1060821-00
—
FL
05
—
1060821-01
—
FL
Enumeration date
10/04/2005
Last updated
08/11/2010
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