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Organization

SUFFOLK HOME MEDICAL

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. THOMAS INMAN (OWNER)
(941) 473-1187
Entity
Organization

Contact information

Practice address
815 W CONSTANCE RD, SUFFOLK, VA 23434-5649
(757) 539-2772
(757) 539-5037
Mailing address
47 GRAND PALMS BLVD, ENGLEWOOD, FL 34223-1808
(941) 473-1187
(941) 473-1187

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
001878
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
009133321
VA
01
062865
PROVIDER NUMBER(BCBS)
VA
01
7700372
DMAS PROVIDER NUMBER
NC
Enumeration date
10/18/2006
Last updated
10/02/2008
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