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NPI 1477461515

NPI 1477461515 : CRESTWOOD GLOBAL LLC : CHARLOTTE, NC

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General NPI Number Information
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    NPI Number           |    1477461515
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    Entity Type          |    Organization 
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    Legal Business Name  |    CRESTWOOD GLOBAL LLC 
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Dates
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    Enumeration Date     |    08/31/2026
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    Last Update Date     |    08/31/2026
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Provider Practice Location Address
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    Address Line         |    4111E ROSE LAKE DR # 10238 
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    City                 |    CHARLOTTE
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    State                |    NC
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    Zip                  |    28217-2858
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    Country              |    US
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    Telephone            |    910-779-2597
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    4111E ROSE LAKE DR # 10238 
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    City                 |    CHARLOTTE
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    State                |    NC
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    Zip                  |    28217-2858
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    Country              |    US
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    Telephone            |    910-779-2597
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    Fax                  |    
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Authorized Official
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    Title or Position    |    CEO
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    Name                 |     JADA SHADEE  MCEACHERN 
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    Credential           |    
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    Telephone            |    910-779-2597
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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       |    
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    License Number State |    
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