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General NPI Number Information
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NPI Number | 1346252988
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Entity Type | Organization
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Legal Business Name | MED-EQUIP, INC
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Dates
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Enumeration Date | 08/12/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2515 E OZARK AVE
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City | GASTONIA
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State | NC
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Zip | 28054-1423
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Country | US
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Telephone | 704-868-3132
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Fax | 704-868-3133
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Provider Business Mailing Address
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Address Line | 2515 E OZARK AVE
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City | GASTONIA
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State | NC
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Zip | 28054-1423
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Country | US
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Telephone | 704-868-3132
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Fax | 704-868-3133
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | LEROY FRANKLIN IVESTER
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Credential |
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Telephone | 704-868-3132
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number | 502503632162
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License Number State | NC
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