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General NPI Number Information
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NPI Number | 1164415378
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Entity Type | Organization
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Legal Business Name | PRO MED EQUIPMENT AND SUPPLY INC
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Dates
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Enumeration Date | 08/24/2005
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Last Update Date | 07/09/2013
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Provider Practice Location Address
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Address Line | 601 MEMORIAL DR E
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City | AHOSKIE
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State | NC
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Zip | 27910-3935
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Country | US
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Telephone | 252-332-8081
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Fax | 252-332-8091
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Provider Business Mailing Address
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Address Line | 601 MEMORIAL DR E
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City | AHOSKIE
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State | NC
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Zip | 27910-3935
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Country | US
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Telephone | 252-332-8081
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Fax | 252-332-8091
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Authorized Official
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Title or Position | OWNERVICE PRESIDENT
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Name | MRS. CYNDI W CHAMBLEE
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Credential |
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Telephone | 252-332-8081
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BP3500X
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Taxonomy Name | Parenteral & Enteral Nutrition Supplies (DME)
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License Number |
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number | 00609
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License Number State | NC
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