Provider Demographics
NPI:1487081840
Name:ALBROOK MEDICAL, INC.
Entity type:Organization
Organization Name:ALBROOK MEDICAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:KEITH
Authorized Official - Last Name:PADGETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:386-451-6089
Mailing Address - Street 1:5889 S WILLIAMSON BLVD
Mailing Address - Street 2:SUITE 1405
Mailing Address - City:PORT ORANGE
Mailing Address - State:FL
Mailing Address - Zip Code:32128-7134
Mailing Address - Country:US
Mailing Address - Phone:386-761-0911
Mailing Address - Fax:386-761-0915
Practice Address - Street 1:5889 S WILLIAMSON BLVD
Practice Address - Street 2:SUITE 1405
Practice Address - City:PORT ORANGE
Practice Address - State:FL
Practice Address - Zip Code:32128-7134
Practice Address - Country:US
Practice Address - Phone:386-761-0911
Practice Address - Fax:386-761-0915
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-01
Last Update Date:2013-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies