Healthcare Provider Details

I. General information

NPI: 1194166454
Provider Name (Legal Business Name): CALDWELL MEDICAL EQUIPMENT AND SUPPLIES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2013
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 CENTRAL ST
HUDSON NC
28638-2401
US

IV. Provider business mailing address

510 CENTRAL ST
HUDSON NC
28638-2401
US

V. Phone/Fax

Practice location:
  • Phone: 828-728-3561
  • Fax: 828-728-3106
Mailing address:
  • Phone: 828-728-3561
  • Fax: 828-728-3106

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VII. Legacy identifiers

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

VIII. Authorized Official

Name: MR. KEVIN MCKINLEY REECE
Title or Position: GENERAL MANAGER
Credential:
Phone: 828-728-3561