Eagle One Medical, Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

EAGLE ONE MEDICAL, INC.

Practice address

644 Cesery Blvd Ste 101
Jacksonville, FL 32211-7165

Phone

(904) 647-7150

Fax

(904) 551-2462

NPI assigned

Feb 1, 2018

Organization subpart

No

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

Authorized official

Name

Joseph Kelly

Title

Owner

Phone

(904) 647-7150

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1517443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1517443200000",
    "number": "1215436548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "644 CESERY BLVD STE 101",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322117165",
            "telephone_number": "904-647-7150",
            "fax_number": "904-551-2462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "644 CESERY BLVD STE 101",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322117165",
            "telephone_number": "904-647-7150",
            "fax_number": "904-551-2462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLE ONE MEDICAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-01",
        "last_updated": "2018-02-01",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-647-7150"
    },
    "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 Jacksonville, FL
• Providers in Jacksonville, 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 Feb 1, 2018; 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.