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General NPI Number Information
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NPI Number | 1265442941
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Entity Type | Organization
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Legal Business Name | HEARTLINE MEDICAL LLC
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Dates
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Enumeration Date | 08/08/2006
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Last Update Date | 03/18/2010
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Provider Practice Location Address
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Address Line | 14679 US HIGHWAY 17 N
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City | HAMPSTEAD
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State | NC
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Zip | 28443-0055
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Country | US
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Telephone | 910-270-2200
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Fax | 910-270-0203
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Provider Business Mailing Address
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Address Line | PO BOX 55
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City | HAMPSTEAD
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State | NC
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Zip | 28443-0055
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Country | US
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Telephone | 910-270-2200
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Fax | 910-270-0203
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Authorized Official
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Title or Position | OWNER
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Name | MR. BRAD L VOGEL
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Credential |
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Telephone | 910-270-2200
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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 | 00957
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License Number State | NC
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