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General NPI Number Information
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NPI Number | 1548291917
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Entity Type | Organization
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Legal Business Name | MARY CARVER-BAYSDON
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Dates
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Enumeration Date | 07/05/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 2201 -C NORTH PINE STREET
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City | LUMBERTON
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State | NC
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Zip | 28358
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Country | US
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Telephone | 910-272-9900
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3576
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City | LUMBERTON
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State | NC
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Zip | 28359
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Country | US
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Telephone | 910-272-9900
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. MARY L CARVER-BAYSDON
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Credential | CFO/DME
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Telephone | 910-272-9900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number | 312892
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License Number State | NC
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