Provider Demographics
NPI:1154186013
Name:MAYRX RECOVERY
Entity type:Organization
Organization Name:MAYRX RECOVERY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:WINEBARGER
Authorized Official - Last Name:BYNNOM
Authorized Official - Suffix:
Authorized Official - Credentials:LCAS
Authorized Official - Phone:828-442-9599
Mailing Address - Street 1:302 STONE RIDGE BLVD
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28804-8313
Mailing Address - Country:US
Mailing Address - Phone:828-845-1020
Mailing Address - Fax:
Practice Address - Street 1:302 STONE RIDGE BLVD
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28804-8313
Practice Address - Country:US
Practice Address - Phone:828-845-1020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MAYRX
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-02-19
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty