Organization
MASH INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GREGORY L HORN (PRESIDENT)
(205) 664-2059
Entity
Organization
Contact information
Practice address
242 NE RACETRACK RD, FORT WALTON BEACH, FL 32547
(850) 863-4515
(850) 863-4515
Mailing address
242 NE RACETRACK RD, FORT WALTON BEACH, FL 32547
(850) 863-4515
(850) 863-1319
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
027450000
—
FL
05
—
201611701
—
FL
05
—
672310196
—
FL
05
—
672312896
—
FL
05
—
672312898
—
FL
01
—
R3414
BLUE CROSS BLUE SHIELD
FL
Enumeration date
04/03/2006
Last updated
04/28/2011
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