MEDICARE: BUDDY ENTERPRIZES, 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	0206009431	VA
2	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1548430705
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BUDDY ENTERPRIZES, LLC

Provider Business Mailing Address
First Line	:	1601 WARE BOTTOM SPRING RD STE 209
Second Line	:
City	:	CHESTER
State	:	VA
Zip	:	23836-2599
Country	:	US
Telephone Number	:	804-318-3826
Fax Number	:	804-318-3833

Provider Business Practice Location Address
First Line	:	1601 WARE BOTTOM SPRING RD STE 209
Second Line	:
City	:	CHESTER
State	:	VA
Zip	:	23836-2599
Country	:	US
Telephone Number	:	804-318-3826
Fax Number	:	804-318-3833

Authorized Official
Title or Position	:	CO OWNER
Name	:	MRS. CYNTHIA ASHAUNTA CARNEY
Credential	:
Telephone Number	:	804-318-3826

Provider Enumeration Date	:	03/04/2008
Last Update Date	:	05/19/2008

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Directions to “BUDDY ENTERPRIZES, LLC ” Practice Location

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