Organization
MDK VENTURES L.L.C
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
4265 TAMIAMI TRL, UNIT E, PORT CHARLOTTE, FL 33980-2152
(941) 637-7330
(941) 637-6582
Mailing address
752 COMMERCE DR, SUITE 5, VENICE, FL 34292-1744
(941) 584-6154
(877) 497-1030
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
1313157
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
025612900
—
FL
Enumeration date
04/18/2008
Last updated
08/17/2010
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