Organization
LONGS HOME MED SRVC AND EQUIP INC.
Active
Other names
Long's Home Medical
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DOTTIE CULLEN (CEO)
(352) 735-1120
Entity
Organization
Contact information
Practice address
3801 N HIGHWAY 19A, STE 408, MOUNT DORA, FL 32757-2228
(352) 735-1120
(352) 735-1137
Mailing address
3801 N HIGHWAY 19A, STE 408, MOUNT DORA, FL 32757-2228
(352) 735-1120
(352) 735-1137
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
1312180
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
026896800
—
FL
01
—
R5491
BCBS FEDERAL PROVIEDER ID
FL
Enumeration date
10/06/2006
Last updated
06/02/2011
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