MEDICARE: LOCKLEAR MEDICAL SUPPLIES,INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies		NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	045MM	OTHER	NC	BCBS

General Provider Information

NPI Number	:	1023088432
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOCKLEAR MEDICAL SUPPLIES,INC

Provider Business Mailing Address
First Line	:	114 N PATTERSON ST
Second Line	:
City	:	MAXTON
State	:	NC
Zip	:	28364-1735
Country	:	US
Telephone Number	:	910-844-1001
Fax Number	:	910-844-1035

Provider Business Practice Location Address
First Line	:	114 N PATTERSON ST.
Second Line	:
City	:	MAXTON
State	:	NC
Zip	:	28364
Country	:	US
Telephone Number	:	910-844-1001
Fax Number	:	910-844-1035

Authorized Official
Title or Position	:	OFFICE MANGER
Name	:	MS. VELISSA M LOCKLEAR
Credential	:	COFM
Telephone Number	:	910-844-1001

Provider Enumeration Date	:	01/26/2006
Last Update Date	:	09/29/2011

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Directions to “LOCKLEAR MEDICAL SUPPLIES,INC ” Practice Location

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