Organization
BREVARD MEDICAL EQUIPMENT, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREG P BONENBERGER (VICE-PRESIDENT)
(321) 453-3370
Entity
Organization
Contact information
Practice address
105 N BANANA RIVER DR, MERRITT ISLAND, FL 32952-2546
(321) 453-3370
Mailing address
105 N BANANA RIVER DR, MERRITT ISLAND, FL 32952-2546
(321) 453-3370
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
1312632
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
030894300
—
FL
Enumeration date
07/22/2005
Last updated
09/30/2008
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