MEDICARE: LARRY BURNETT & ASSOCIATES, 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	000314484	NC

General Provider Information

NPI Number	:	1689792020
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LARRY BURNETT & ASSOCIATES, INC.

Provider Business Mailing Address
First Line	:	2911 HOPEWOOD LN
Second Line	:
City	:	WINSTON SALEM
State	:	NC
Zip	:	27103-9777
Country	:	US
Telephone Number	:	336-766-8680
Fax Number	:	336-712-1512

Provider Business Practice Location Address
First Line	:	2911 HOPEWOOD LN
Second Line	:
City	:	WINSTON SALEM
State	:	NC
Zip	:	27103-9777
Country	:	US
Telephone Number	:	336-766-4615
Fax Number	:	336-712-1512

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. LARRY FRANCIS BURNETT
Credential	:
Telephone Number	:	336-766-4615

Provider Enumeration Date	:	03/26/2007
Last Update Date	:	12/02/2008

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