Peritoneal Dialysis Supply, LLC

Primary specialty

Dialysis Equipment & Supplies (DME)Taxonomy code 332BD1200X

Legal business name

PERITONEAL DIALYSIS SUPPLY, LLC

Practice address

1964 Bayshore Blvd
Suite C
Dunedin, FL 34698-2576

Phone

(727) 738-5255

Fax

(727) 733-0431

NPI assigned

Aug 25, 2005

Last updated

Apr 10, 2008By 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

Mrs. June A. Clark

Title

Business Manager

Phone

(727) 738-5255

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1124928000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207785600000",
    "number": "1275526113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1964 BAYSHORE BLVD SUITE C",
            "city": "DUNEDIN",
            "state": "FL",
            "postal_code": "346982576",
            "telephone_number": "727-738-5255",
            "fax_number": "727-733-0431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1964 BAYSHORE BLVD",
            "address_2": "SUITE C",
            "city": "DUNEDIN",
            "state": "FL",
            "postal_code": "346982576",
            "telephone_number": "727-738-5255",
            "fax_number": "727-733-0431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERITONEAL DIALYSIS SUPPLY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-25",
        "last_updated": "2008-04-10",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "JUNE",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "727-738-5255",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332BD1200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Dialysis Equipment & Supplies",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patrice Moreno MD
• Robert William Patton Jr., M.D., J.D.
• Mary Teresa Paxson, R.D.H.
• Pedersen Medicine PLLC (Highland Health Center)
• Pediatrix Medical Group of Florida Inc
• Esha Persad, DDS
• Andrea P. Pesce-Guttveg, LIC. ACUPUNCTURIST
• Lindsey Peters, RDN
• Jennifer Kaye Peterson, DC
• Victoria Dawn Peterson, BCABA

• Durable Medical Equipment & Medical Supplies in Dunedin, FL
• Providers in Dunedin, 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 Apr 10, 2008; 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.