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General NPI Number Information
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NPI Number | 1962604587
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Entity Type | Organization
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Legal Business Name | CVC HOME MEDICAL, INC
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Dates
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Enumeration Date | 06/05/2007
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Last Update Date | 07/06/2009
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Provider Practice Location Address
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Address Line | 3302 BRIDGES ST SUITE C
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City | MOREHEAD CITY
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State | NC
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Zip | 28557-2983
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Country | US
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Telephone | 252-726-3556
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Fax | 252-726-4227
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Provider Business Mailing Address
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Address Line | 3302 BRIDGES ST SUITE C
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City | MOREHEAD CITY
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State | NC
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Zip | 28557-2983
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Country | US
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Telephone | 252-726-3556
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Fax | 252-726-4227
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER
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Name | JERRY A STANLEY
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Credential |
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Telephone | 252-726-3556
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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 | CFM00768
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License Number State | NC
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