Healthcare Provider Details

I. General information

NPI: 1225860455
Provider Name (Legal Business Name): A1 MEDICAL EQUIPMENT AND SUPPLY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2024
Last Update Date: 08/28/2025
Certification Date: 08/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5820 E W T HARRIS BLVD STE 208
CHARLOTTE NC
28215-4032
US

IV. Provider business mailing address

PO BOX 680141
CHARLOTTE NC
28216-0003
US

V. Phone/Fax

Practice location:
  • Phone: 704-919-0096
  • Fax:
Mailing address:
  • Phone: 704-919-0096
  • Fax:

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 Code332BD1200X
TaxonomyDialysis Equipment & Supplies (DME)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: LUCRETIA JOYNER PARKER
Title or Position: MANAGING DIRECTOR
Credential:
Phone: 980-808-6561