MEDICARE: CVC HOME MEDICAL, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332BX2000X	Oxygen Equipment & Supplies (DME)	694	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184627812
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CVC HOME MEDICAL, INC.

Provider Business Mailing Address
First Line	:	PO BOX 10731
Second Line	:
City	:	WILMINGTON
State	:	NC
Zip	:	28404-0731
Country	:	US
Telephone Number	:	910-686-3599
Fax Number	:	910-686-3499

Provider Business Practice Location Address
First Line	:	8114 MARKET ST
Second Line	:	STE 100
City	:	WILMINGTON
State	:	NC
Zip	:	28411-9386
Country	:	US
Telephone Number	:	910-686-3599
Fax Number	:	910-686-3499

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. GARLAND WASHINGTON SEWELL JR.
Credential	:	RPH
Telephone Number	:	910-326-3349

Provider Enumeration Date	:	05/27/2005
Last Update Date	:	01/30/2012

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Directions to “CVC HOME MEDICAL, INC. ” Practice Location

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