| NPI | 1962676189 |
|---|---|
| Doing Business As | MEDICAL DEPARTMENT STORE |
| Entity Type | Organization |
| Authorized Contact | KEVIN WILLIAM MCCORD Managing Member 941-232-8585 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: FL 1313157) |
| Enumeration Date | 2008-04-18 |
| Last Update Date | 2010-08-17 |