Healthcare Provider Details

I. General information

NPI: 1801543319
Provider Name (Legal Business Name): RALEIGH'S DURABLE MEDICAL SUPPLY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2022
Last Update Date: 06/27/2022
Certification Date: 06/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 KEISLER DR STE A1
CARY NC
27518-7018
US

IV. Provider business mailing address

301 KEISLER DR STE A1
CARY NC
27518-7018
US

V. Phone/Fax

Practice location:
  • Phone: 198-420-0177
  • Fax: 984-200-1827
Mailing address:
  • Phone: 984-200-1777
  • Fax: 984-200-4290

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: FELICE SALENA REED
Title or Position: OWNER
Credential:
Phone: 773-827-1230