Organization
MASH INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GREGORY L HORN (PRESIDENT)
(205) 664-2059
Entity
Organization
Contact information
Practice address
1505 B SOUTH FERDON BLVD, CRESTVIEW, FL 32536
(850) 682-9777
(850) 682-2996
Mailing address
1505 B SOUTH FERDON BLVD, CRESTVIEW, FL 32536
(850) 682-9777
(850) 682-2996
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
027707000
—
FL
01
—
R3303
BLUE CROSS BLUE SHIELD
FL
Enumeration date
04/04/2006
Last updated
07/14/2015
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