Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Nursing Facility Supplies |
332BN1400X | 87 | All Other Suppliers |
| NPI Number | 1407967938 |
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| LBN Legal business name | FOUR SEASONS MEDICAL SUPPLY, INC | ||||||||
| Authorized official | JEANNE TAYLOR - (BILLER) | ||||||||
| Entity | Organization | ||||||||
| Organization subpart 1 | No | ||||||||
| Enumeration date | 08/31/2006 | ||||||||
| Last updated | 11/10/2009 - About 17 years ago | ||||||||
| Identifiers |
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