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General NPI Number Information
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NPI Number | 1669659017
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Entity Type | Organization
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Legal Business Name | OCR-RA ACQUISITION, LLC
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Dates
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Enumeration Date | 01/29/2008
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Last Update Date | 11/13/2008
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Provider Practice Location Address
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Address Line | 700 S HOLDEN RD
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City | GREENSBORO
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State | NC
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Zip | 27407-2321
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Country | US
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Telephone | 336-547-2988
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Fax |
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Provider Business Mailing Address
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Address Line | 100 E RIVERCENTER BLVD SUITE 1600
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City | COVINGTON
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State | KY
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Zip | 41011-1555
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SECRETARY
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Name | REGIS ROBBINS
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Credential |
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Telephone | 859-392-3300
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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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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 09979
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License Number State | NC
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