Healthcare Provider Details

I. General information

NPI: 1326702093
Provider Name (Legal Business Name): DJOI INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2021
Last Update Date: 01/10/2022
Certification Date: 01/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

905 MEBANE OAKS RD
MEBANE NC
27302-9780
US

IV. Provider business mailing address

615 BUNKER DR
MEBANE NC
27302-9819
US

V. Phone/Fax

Practice location:
  • Phone: 336-380-7834
  • Fax:
Mailing address:
  • Phone: 919-309-5411
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code246RM2200X
TaxonomyMedical Laboratory Technician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: MR. COREY FREEMAN
Title or Position: OWNER
Credential:
Phone: 919-309-5411