OrganizationActive
Active Living Store Inc.
NPI 1871633073 · Durable Medical Equipment & Medical Supplies · Summerfield, FL
Provider details
- NPI number
- 1871633073
- Entity type
- Organization
- Primary specialty
- Durable Medical Equipment & Medical SuppliesSuppliers
- Organization subpart
- No
- Authorized official
- Page Whittle, Vice President(352) 307-3511
- License
- 1626 (FL)
Specialties & taxonomies
Suppliers
Profile Score
Detailed profile(90/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
17860 Se 109th Ave
#630
Summerfield, FL 34491-8911
Phone: (352) 307-3511
Fax: (352) 307-1151
Street-level locationGet directions
Mailing address
Po Box 492936
Leesburg, FL 34749-2936
Registry dates
- Enumerated
- 2007-02-07
- Last updated
- 2020-08-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.