Healthcare Provider Details

I. General information

NPI: 1265511547
Provider Name (Legal Business Name): COMMUNITY MEDICAL SUPPLIES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2006
Last Update Date: 02/27/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

480 E 9TH ST
LUMBERTON NC
28358-4880
US

IV. Provider business mailing address

PO BOX 3576
LUMBERTON NC
28359-3576
US

V. Phone/Fax

Practice location:
  • Phone: 910-272-9900
  • Fax: 910-671-1983
Mailing address:
  • Phone: 910-272-9900
  • Fax: 910-671-1983

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: MRS. MARY L BAYSDON
Title or Position: PRESIDENT
Credential:
Phone: 910-272-9900