Healthcare Provider Details

I. General information

NPI: 1225447980
Provider Name (Legal Business Name): MEDPARTNERS, CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2014
Last Update Date: 01/25/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 AIRPORT RD STE 2
FLETCHER NC
28732-6712
US

IV. Provider business mailing address

450 AIRPORT RD STE 2
FLETCHER NC
28732-6712
US

V. Phone/Fax

Practice location:
  • Phone: 888-572-3330
  • Fax: 888-579-6040
Mailing address:
  • Phone: 888-572-3330
  • Fax: 888-579-6040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number02197
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number02197
License Number StateNC

VIII. Authorized Official

Name: MR. PHIL D BLAND
Title or Position: PRESIDENT
Credential:
Phone: 828-283-2728