Provider Demographics
NPI:1962111898
Name:MED-GO MEDICAL SUPPLIES & RESOURCE CENTER
Entity type:Organization
Organization Name:MED-GO MEDICAL SUPPLIES & RESOURCE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LOVELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:WARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-901-6083
Mailing Address - Street 1:2468 US HIGHWAY 441/27 STE 202
Mailing Address - Street 2:
Mailing Address - City:FRUITLAND PARK
Mailing Address - State:FL
Mailing Address - Zip Code:34731-2149
Mailing Address - Country:US
Mailing Address - Phone:352-901-6083
Mailing Address - Fax:352-801-7427
Practice Address - Street 1:2468 US HIGHWAY 441/27 STE 202
Practice Address - Street 2:
Practice Address - City:FRUITLAND PARK
Practice Address - State:FL
Practice Address - Zip Code:34731-2149
Practice Address - Country:US
Practice Address - Phone:352-901-6083
Practice Address - Fax:352-801-7427
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-18
Last Update Date:2022-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies