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Organization

MDK VENTURES LLC

Active
Other names
MEDICAL DEPARTMENT STORE
Organization subpart
No

Provider details

NPI number
Authorized official
MR. KEVIN WILLIAM MCCORD (MANAGING MEMBER)
(941) 232-8585
Entity
Organization

Contact information

Practice address
8595 COLLEGE PKWY, UNIT 170, FORT MYERS, FL 33919-5191
(239) 482-6111
(239) 482-6178
Mailing address
752 COMMERCE DR, SUITE 5, VENICE, FL 34292-1744
(941) 584-6154
(941) 497-1030

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
538 AHCA
FL
332BX2000X
Oxygen Equipment & Supplies (DME)
32 6681
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
025612900
FL
Enumeration date
03/20/2008
Last updated
03/01/2010
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