Basic Information
Provider Information
NPI: 1508207267
EntityType: 2
ReplacementNPI:  
OrganizationName: AEROCARE HOME MEDICAL, INC.
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: QUALITY PLUS
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3325 BARTLETT BLVD
Address2:  
City: ORLANDO
State: FL
PostalCode: 328116428
CountryCode: US
TelephoneNumber: 4072060040
FaxNumber: 4072060010
Practice Location
Address1: 210 BEARDEN RD
Address2:  
City: PELHAM
State: AL
PostalCode: 35124
CountryCode: US
TelephoneNumber: 2059885520
FaxNumber: 2059885409
Other Information
ProviderEnumerationDate: 07/10/2013
LastUpdateDate: 07/24/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: GRIGGS
AuthorizedOfficialFirstName: STEPHEN
AuthorizedOfficialMiddleName: P
AuthorizedOfficialTitleorPosition: CEO
AuthorizedOfficialTelephone: 4072060040
IsSoleProprietor:  
IsOrganizationSubpart: Y
ParentOrganizationLBN: AEROCARE HOLDINGS, INC.
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

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

No ID Information.


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