Desoto Home Care

Primary specialty

Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X

License

1919 Issued in FL

Legal business name

DESOTO HOME CARE

Practice address

311 N Marion Ave
Lake City, FL 32055-2866

Phone

(386) 752-1699

Fax

(386) 752-6000

NPI assigned

May 31, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Shaun Grubb

Title

President

Phone

(386) 752-1699

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1117497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1235132671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 N MARION AVE",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320552866",
            "telephone_number": "386-752-1699",
            "fax_number": "386-752-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 N MARION AVE",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320552866",
            "telephone_number": "386-752-1699",
            "fax_number": "386-752-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESOTO HOME CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GRUBB",
        "authorized_official_first_name": "SHAUN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "386-752-1699",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "FL",
            "license": "1919",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "R9451",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Deonna G Willis Aprn LLC
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• Departmentf Veterans Affairs
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• Jennifer Lee Devries, R.D.
• Luz S Diaz, PT
• Danielle Dinger, LCSW
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• Lakiesha Dixon

• Oxygen Equipment & Supplies (DME) in Lake City, FL
• Providers in Lake City, FL by specialty
• Oxygen Equipment & Supplies (DME) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.