Basic Information
Provider Information
NPI: 1073128963
EntityType: 2
ReplacementNPI:  
OrganizationName: MADISON COUNTY MEDICAL EQUIPMENT, INC.
LastName:  
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Mailing Information
Address1: 3325 BARTLETT BLVD
Address2:  
City: ORLANDO
State: FL
PostalCode: 328116428
CountryCode: US
TelephoneNumber: 4072060040
FaxNumber: 4072060010
Practice Location
Address1: 213 E MAIN ST STE 102
Address2:  
City: KNOXVILLE
State: IA
PostalCode: 501382502
CountryCode: US
TelephoneNumber: 6418206101
FaxNumber: 8668206101
Other Information
ProviderEnumerationDate: 09/09/2020
LastUpdateDate: 09/09/2020
NPIDeactivationReasonCode:  
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AuthorizedOfficialLastName: GRIGGS
AuthorizedOfficialFirstName: STEPHEN
AuthorizedOfficialMiddleName: P
AuthorizedOfficialTitleorPosition: CEO/PRESIDENT
AuthorizedOfficialTelephone: 4072060040
IsSoleProprietor:  
IsOrganizationSubpart: Y
ParentOrganizationLBN: AEROCARE HOLDINGS, INC.
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NPICertificationDate: 09/09/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
332BX2000X  Y SuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies

No ID Information.


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