Provider Demographics
NPI:1154433654
Name:PC INDUSTRIES
Entity type:Organization
Organization Name:PC INDUSTRIES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAYE
Authorized Official - Middle Name:O
Authorized Official - Last Name:CRENSHAW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-231-7774
Mailing Address - Street 1:1021 EXECUTIVE BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-3665
Mailing Address - Country:US
Mailing Address - Phone:757-382-7111
Mailing Address - Fax:757-382-0111
Practice Address - Street 1:1021 EXECUTIVE BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-3665
Practice Address - Country:US
Practice Address - Phone:757-382-7111
Practice Address - Fax:757-382-0111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment