Healthcare Provider Details
I. General information
NPI: 1215037700
Provider Name (Legal Business Name): DURAMEDIX HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/24/2006
Last Update Date: 02/02/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4837 TAYLORSVILLE HWY
STONY POINT NC
28678-9050
US
IV. Provider business mailing address
PO BOX 6474
HIGH POINT NC
27262-6474
US
V. Phone/Fax
- Phone: 704-438-8132
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332BC3200X |
| Taxonomy | Customized Equipment (DME) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CURTIS
F.
GREGORY
Title or Position: OWNER
Credential:
Phone: 704-438-8132