Provider Demographics
NPI: | 1427650274 |
---|---|
Name: | MADISON COUNTY MEDICAL EQUIPMENT, INC |
Entity type: | Organization |
Organization Name: | MADISON COUNTY MEDICAL EQUIPMENT, INC |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | CEO |
Authorized Official - Prefix: | |
Authorized Official - First Name: | STEPHEN |
Authorized Official - Middle Name: | P |
Authorized Official - Last Name: | GRIGGS |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 407-206-0040 |
Mailing Address - Street 1: | 3325 BARTLETT BLVD |
Mailing Address - Street 2: | |
Mailing Address - City: | ORLANDO |
Mailing Address - State: | FL |
Mailing Address - Zip Code: | 32811-6428 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 407-515-2070 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 1505 W BROADWAY STE 4 |
Practice Address - Street 2: | |
Practice Address - City: | COUNCIL BLUFFS |
Practice Address - State: | IA |
Practice Address - Zip Code: | 51501-3966 |
Practice Address - Country: | US |
Practice Address - Phone: | 712-524-2200 |
Practice Address - Fax: | 712-524-2201 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | Yes |
Parent Organization LBN: | AEROCARE HOLDINGS, INC. |
Parent Organization TIN: | <UNAVAIL> |
Enumeration Date: | 2020-11-16 |
Last Update Date: | 2021-06-07 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 332BX2000X | Suppliers | Durable Medical Equipment & Medical Supplies | Oxygen Equipment & Supplies |