Healthcare Provider Details

I. General information

NPI: 1790785541
Provider Name (Legal Business Name): DRESSEN MEDICAL SUPPLY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2005
Last Update Date: 12/11/2020
Certification Date: 12/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

156 THOMAS MILL RD
HOLLY SPRINGS NC
27540-9372
US

IV. Provider business mailing address

PO BOX 248
HOLLY SPRINGS NC
27540-0248
US

V. Phone/Fax

Practice location:
  • Phone: 919-577-6458
  • Fax: 919-577-6459
Mailing address:
  • Phone: 919-577-6458
  • Fax: 919-577-6459

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number756
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number756
License Number StateNC
# 4
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number756
License Number StateNC

VIII. Authorized Official

Name: MR. EDWARD J. DRESSEN
Title or Position: VP OF OPERATIONS
Credential:
Phone: 919-577-6458