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General NPI Number Information
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NPI Number | 1376866699
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Entity Type | Organization
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Legal Business Name | BROGDEN CORPORATION
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Dates
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Enumeration Date | 03/02/2010
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Last Update Date | 03/02/2010
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Provider Practice Location Address
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Address Line | 4446 US HIGHWAY 220 N STE C
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City | SUMMERFIELD
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State | NC
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Zip | 27358-9415
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Country | US
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Telephone | 336-644-7058
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Fax | 336-644-7297
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Provider Business Mailing Address
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Address Line | 4446 US HIGHWAY 220 N STE C
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City | SUMMERFIELD
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State | NC
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Zip | 27358-9415
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Country | US
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Telephone | 336-644-7058
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Fax | 336-644-7297
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Authorized Official
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Title or Position | OWNER
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Name | MR. HARRY LEE BROGDEN JR.
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Credential | RPH
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Telephone | 336-644-7058
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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 | 08993
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License Number State | NC
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