Provider Demographics
NPI:1194264002
Name:NATIONAL MED GROUP, LLC
Entity type:Organization
Organization Name:NATIONAL MED GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMAO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-701-1552
Mailing Address - Street 1:9 E LOOCKERMAN ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19901-8306
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9 E LOOCKERMAN ST
Practice Address - Street 2:SUITE 202
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19901-8306
Practice Address - Country:US
Practice Address - Phone:844-492-9649
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-13
Last Update Date:2017-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies