Provider Demographics
NPI:1194242867
Name:HC DAVENPORT DME, INC
Entity type:Organization
Organization Name:HC DAVENPORT DME, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/ CEO
Authorized Official - Prefix:
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:B
Authorized Official - Last Name:HILL
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:863-422-1737
Mailing Address - Street 1:108 PARK PLACE BLVD STE C
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:FL
Mailing Address - Zip Code:33837-6877
Mailing Address - Country:US
Mailing Address - Phone:863-422-1737
Mailing Address - Fax:407-681-4603
Practice Address - Street 1:108 PARK PLACE BLVD
Practice Address - Street 2:SUITE C
Practice Address - City:DAVENPORT
Practice Address - State:FL
Practice Address - Zip Code:33837
Practice Address - Country:US
Practice Address - Phone:863-422-1737
Practice Address - Fax:407-681-4603
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies