Organization
MEDRENTAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SAMANTHA RAY DAVIS (SEC TREAS)
(205) 364-9800
Entity
Organization
Contact information
Practice address
25660 HIGHWAY 82, GORDO, AL 35466-2261
(205) 364-9800
(205) 364-1304
Mailing address
PO BOX 304, GORDO, AL 35466-0304
(205) 364-9800
(205) 364-1304
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
403
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00440925
—
MS
05
—
009981640
—
AL
01
—
51500370MED
BLUECROSS BLUESHIELD
AL
Enumeration date
08/12/2005
Last updated
08/12/2014
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