MEDICARE: JAMES DRUWE CPO

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	222Z00000X	Orthotist
2	224P00000X	Prosthetist

General Provider Information

NPI Number	:	1386993038
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES DRUWE CPO

Provider Business Mailing Address
First Line	:	113 KANDEMOR LN
Second Line	:
City	:	ROCKY MOUNT
State	:	NC
Zip	:	27804-3212
Country	:	US
Telephone Number	:	252-443-5116
Fax Number	:	252-443-5347

Provider Business Practice Location Address
First Line	:	113 KANDEMOR LN
Second Line	:
City	:	ROCKY MOUNT
State	:	NC
Zip	:	27804-3212
Country	:	US
Telephone Number	:	252-443-5116
Fax Number	:	252-443-5347

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/07/2012
Last Update Date	:	09/07/2012

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