Provider Demographics
NPI:1104176965
Name:DRAINVILLE ENTERPRISES, INC
Entity type:Organization
Organization Name:DRAINVILLE ENTERPRISES, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:LAMAR
Authorized Official - Last Name:KENT
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:910-670-8976
Mailing Address - Street 1:504 CUMBERLAND ST
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28301-4620
Mailing Address - Country:US
Mailing Address - Phone:910-779-1930
Mailing Address - Fax:910-307-3085
Practice Address - Street 1:504 CUMBERLAND ST
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28301-4620
Practice Address - Country:US
Practice Address - Phone:910-779-1930
Practice Address - Fax:910-307-3085
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOME MEDICAL EQUIPMENT OF CHATHAM COUNTY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-09-19
Last Update Date:2015-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC4736250002Medicare NSC