Healthcare Provider Details

I. General information

NPI: 1063343556
Provider Name (Legal Business Name): ANCHOR HEARTS MEDICAL SUPPLIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1216 E LITTLE CREEK RD STE 200B
NORFOLK VA
23518-3900
US

IV. Provider business mailing address

8015 GALVESTON BLVD
NORFOLK VA
23505-1508
US

V. Phone/Fax

Practice location:
  • Phone: 919-247-4984
  • Fax: 434-208-2397
Mailing address:
  • Phone: 919-247-4984
  • Fax: 434-208-2397

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BD1200X
TaxonomyDialysis Equipment & Supplies (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BN1400X
TaxonomyNursing Facility Supplies (DME)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: RAPHERNEST ODOEMENE
Title or Position: DIRECTOR
Credential: ODOEMENE
Phone: 919-247-4984