Healthcare Provider Details

I. General information

NPI: 1568623759
Provider Name (Legal Business Name): A PLUS HOME MEDICAL & RESPIRATORY EQUIPMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2008
Last Update Date: 07/23/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1548 NC HIGHWAY 211 W
LUMBERTON NC
28360-3696
US

IV. Provider business mailing address

1548 NC HIGHWAY 211 W
LUMBERTON NC
28360-3696
US

V. Phone/Fax

Practice location:
  • Phone: 910-735-0500
  • Fax: 910-735-0200
Mailing address:
  • Phone: 910-735-0500
  • Fax: 910-735-0200

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number00982
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number00982
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number00982
License Number StateNC
# 4
Primary TaxonomyN
Taxonomy Code333300000X
TaxonomyEmergency Response System Companies
License Number00982
License Number StateNC
# 5
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number00982
License Number StateNC

VIII. Authorized Official

Name: ANISSA EMANUEL BULLARD
Title or Position: OWNER
Credential: PA, MHS, LPN
Phone: 910-735-0500