MEDICARE: LONDON MEDICAL SUPPLY LLC

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

General Provider Information

NPI Number	:	1386137727
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LONDON MEDICAL SUPPLY LLC

Provider Business Mailing Address
First Line	:	12335 WAKE UNION CHURCH RD STE 207
Second Line	:
City	:	WAKE FOREST
State	:	NC
Zip	:	27587-4527
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	12335 WAKE UNION CHURCH RD STE 207
Second Line	:
City	:	WAKE FOREST
State	:	NC
Zip	:	27587-4527
Country	:	US
Telephone Number	:	919-435-0018
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JAMES FOLEY
Credential	:
Telephone Number	:	919-435-0018

Provider Enumeration Date	:	06/11/2018
Last Update Date	:	04/28/2020

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Directions to “LONDON MEDICAL SUPPLY LLC ” Practice Location

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