Healthcare Provider Details

I. General information

NPI: 1780989186
Provider Name (Legal Business Name): TRIAD MOBILITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/14/2011
Last Update Date: 01/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7917 NC 67 HWY
EAST BEND NC
27018-8055
US

IV. Provider business mailing address

7917 NC 67 HWY
EAST BEND NC
27018-8055
US

V. Phone/Fax

Practice location:
  • Phone: 336-699-3959
  • Fax: 336-699-4139
Mailing address:
  • Phone: 336-699-3959
  • Fax: 336-699-4139

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: KENDRA WIDNER
Title or Position: PARTNER
Credential:
Phone: 336-699-3959