North Florida Medical Sales and Rentals of Starke, Inc.

Primary specialty

Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X

License

1313184 Issued in FL

Legal business name

NORTH FLORIDA MEDICAL SALES AND RENTALS OF STARKE, INC.

Practice address

407 W Madison St
Starke, FL 32091-3925

Phone

(904) 368-0202

NPI assigned

Jan 24, 2007

Last updated

Aug 22, 2020By 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. Sid Duane Russell

Title

Vice President

Phone

(904) 368-0202

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1669527339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 W MADISON ST",
            "city": "STARKE",
            "state": "FL",
            "postal_code": "320913925",
            "telephone_number": "904-368-0202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 W MADISON ST",
            "city": "STARKE",
            "state": "FL",
            "postal_code": "320913925",
            "telephone_number": "904-368-0202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH FLORIDA MEDICAL SALES AND RENTALS OF STARKE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "SID",
        "authorized_official_middle_name": "DUANE",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "904-368-0202",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "FL",
            "license": "1313184",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHCA HME AND SERVICES",
            "identifier": "1313184",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL OXYGEN RETAILER",
            "identifier": "326488",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Oxygen Equipment & Supplies (DME) in Starke, FL
• Providers in Starke, 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.