Organization
EAGLE MEDICAL SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN L GREEN (OWNER/PRESIDENT)
(352) 377-5644
Entity
Organization
Contact information
Practice address
6611 SW ARCHER RD, GAINESVILLE, FL 32608-4716
(352) 377-5644
Mailing address
6611 SW ARCHER RD, GAINESVILLE, FL 32608-4716
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R9407
BCBS
FL
Enumeration date
08/09/2006
Last updated
11/27/2007
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