Organization
SUNTREE MEDICAL EQUIPMENT LLC
Active
Other names
Suntree Medical Equipment LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DIAHN CLARK (OWNER)
(321) 259-3400
Entity
Organization
Contact information
Practice address
7640 N WICKHAM RD STE 116, MELBOURNE, FL 32940-8147
(321) 259-3400
(321) 253-3119
Mailing address
7640 N WICKHAM RD, SUITE 116, MELBOURNE, FL 32940-8146
(321) 259-3400
(321) 253-3119
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
PH22488
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2120023
PK
—
Enumeration date
09/14/2006
Last updated
12/16/2016
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