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General NPI Number Information
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NPI Number | 1003034471
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Entity Type | Organization
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Legal Business Name | MEDIDON
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Dates
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Enumeration Date | 04/23/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 213 EXECUTIVE PARK
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City | ASHEVILLE
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State | NC
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Zip | 28801-2427
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Country | US
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Telephone | 877-348-2727
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Fax | 919-869-1934
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Provider Business Mailing Address
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Address Line | 213 EXECUTIVE PARK
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City | ASHEVILLE
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State | NC
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Zip | 28801-2427
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Country | US
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Telephone | 877-348-2727
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Fax | 919-869-1934
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Authorized Official
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Title or Position | CEO
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Name | JEAN ANNE BLAIR
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Credential | CRTT
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Telephone | 877-348-2727
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 07-00019270
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License Number State | NC
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