Healthcare Provider Details

I. General information

NPI: 1588557029
Provider Name (Legal Business Name): ENHANCED MED SUPPLY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2025
Last Update Date: 06/02/2025
Certification Date: 05/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2754 NC-68 UNIT 103
HIGH POINT NC
27265
US

IV. Provider business mailing address

2754 NC-68 UNIT 103
HIGH POINT NC
27265
US

V. Phone/Fax

Practice location:
  • Phone: 336-561-7337
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VII. Legacy identifiers

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

VIII. Authorized Official

Name: JONATHAN TAGER
Title or Position: OWNER
Credential:
Phone: 336-561-7337