Bioderm, Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

BIODERM, INC.

Practice address

12320 73Rd CT
Largo, FL 33773-3011

Phone

(727) 507-7655

Fax

(727) 507-7645

NPI assigned

Mar 19, 2009

Last updated

Jul 24, 2014By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Gary L. Damkoehler

Title

Ceo

Phone

(727) 507-7655

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1237420800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406160000000",
    "number": "1184865230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12320 73RD CT",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337733011",
            "telephone_number": "727-507-7655",
            "fax_number": "727-507-7645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12320 73RD CT",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337733011",
            "telephone_number": "727-507-7655",
            "fax_number": "727-507-7645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BIODERM, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-19",
        "last_updated": "2014-07-24",
        "status": "A",
        "authorized_official_last_name": "DAMKOEHLER",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "727-507-7655",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Largo, FL
• Providers in Largo, FL by specialty
• Durable Medical Equipment & Medical Supplies in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.