Organization
NORTH FLORIDA MEDICAL SALES AND RENTALS OF STARKE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SID DUANE RUSSELL (VICE PRESIDENT)
(904) 368-0202
Entity
Organization
Contact information
Practice address
407 W MADISON ST, STARKE, FL 32091-3925
(904) 368-0202
Mailing address
407 W MADISON ST, STARKE, FL 32091-3925
(904) 368-0202
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
1313184
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1313184
AHCA HME AND SERVICES
FL
01
—
326488
MEDICAL OXYGEN RETAILER
FL
Enumeration date
01/24/2007
Last updated
08/22/2020
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