Healthcare Provider Details

I. General information

NPI: 1497752026
Provider Name (Legal Business Name): ECONOMED OF ABERDEEN INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2005
Last Update Date: 03/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

95 AVIEMORE DR STE A
PINEHURST NC
28374-9797
US

IV. Provider business mailing address

95 AVIEMORE DR STE A
PINEHURST NC
28374-9797
US

V. Phone/Fax

Practice location:
  • Phone: 910-295-4489
  • Fax: 910-215-8035
Mailing address:
  • Phone: 910-295-4489
  • Fax: 910-215-8035

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number StateNC

VIII. Authorized Official

Name: MRS. ELEASE M. GOODWIN
Title or Position: CEO
Credential:
Phone: 910-295-4489