Healthcare Provider Details

I. General information

NPI: 1326191545
Provider Name (Legal Business Name): R AND R IN BELHAVEN LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2007
Last Update Date: 03/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

467 PAMLICO ST
BELHAVEN NC
27810-1421
US

IV. Provider business mailing address

PO BOX 549
BELHAVEN NC
27810-0549
US

V. Phone/Fax

Practice location:
  • Phone: 252-945-0891
  • Fax:
Mailing address:
  • Phone: 252-945-0891
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BD1200X
TaxonomyDialysis Equipment & Supplies (DME)
License Number01248
License Number StateNC

VIII. Authorized Official

Name: MR. JOSEPH REX CARRAWAY
Title or Position: OWNER
Credential:
Phone: 252-945-0891