Professional Products and Services LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

63-00-105098-80-6 Issued in FL

Legal business name

PROFESSIONAL PRODUCTS AND SERVICES LLC

Practice address

2704 Rooks Rd
Davenport, FL 33837-9620

Phone

(863) 240-0422

Fax

(863) 421-9410

NPI assigned

Oct 18, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Anthony James Hall

Title

President

Phone

(863) 421-9400

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

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

{
    "created_epoch": "1192665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691107200000",
    "number": "1497944078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2704 ROOKS RD",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338379620",
            "telephone_number": "863-240-0422",
            "fax_number": "863-421-9410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2704 ROOKS RD",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338379620",
            "telephone_number": "863-240-0422",
            "fax_number": "863-421-9410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL PRODUCTS AND SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-18",
        "last_updated": "2023-08-04",
        "certification_date": "2023-08-04",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "863-421-9400",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "FL",
            "license": "63-00-105098-80-6",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "6405040001",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Davenport, FL
• Providers in Davenport, 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 Aug 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.