Healthcare Provider Details

I. General information

NPI: 1598096513
Provider Name (Legal Business Name): BFRW INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/15/2010
Last Update Date: 01/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2156 US HIGHWAY 70 SE
HICKORY NC
28602-5170
US

IV. Provider business mailing address

2156 US HIGHWAY 70 SE
HICKORY NC
28602-5170
US

V. Phone/Fax

Practice location:
  • Phone: 828-431-4804
  • Fax: 828-431-4805
Mailing address:
  • Phone: 828-431-4804
  • Fax: 828-431-4805

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number332BC3200X
License Number StateNC

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: RALPH EDWARD BRAFFORD JR.
Title or Position: OWNER
Credential:
Phone: 828-431-4804