Provider Demographics
NPI:1124432315
Name:DERMA SLEEVES, LLC
Entity type:Organization
Organization Name:DERMA SLEEVES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER-MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:STUART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-975-4517
Mailing Address - Street 1:102 W. CHESTNUT ST.
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:NC
Mailing Address - Zip Code:27371
Mailing Address - Country:US
Mailing Address - Phone:910-975-4517
Mailing Address - Fax:
Practice Address - Street 1:102 W. CHESTNUT ST.
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:NC
Practice Address - Zip Code:27371
Practice Address - Country:US
Practice Address - Phone:910-975-4517
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-16
Last Update Date:2014-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment