Healthcare Provider Details

I. General information

NPI: 1164581492
Provider Name (Legal Business Name): ZELCO, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2006
Last Update Date: 08/30/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16131 LANCASTER HIGHWAY STE 3
CHARLOTTE NC
28277-2033
US

IV. Provider business mailing address

16131 LANCASTER HIGHWAY STE 3
CHARLOTTE NC
28277
US

V. Phone/Fax

Practice location:
  • Phone: 704-540-4664
  • Fax:
Mailing address:
  • Phone: 704-540-4664
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: KENNETH A ZELIN
Title or Position: OWNER
Credential: C.PED
Phone: 704-540-4664