| NPI | 1174859961 |
|---|---|
| Doing Business As | MEDICAL DEPARTMENT STORE |
| Entity Type | Organization |
| Authorized Contact | KEVIN WILLIAM MCCORD Managing Member/General Manager 941-584-6154 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2009-10-29 |
| Last Update Date | 2010-08-18 |