Provider Demographics
NPI:1194966473
Name:CANTERBURY ENTERPRISES, LLC
Entity type:Organization
Organization Name:CANTERBURY ENTERPRISES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:
Authorized Official - Last Name:BURR
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:804-530-2109
Mailing Address - Street 1:204 RIVERS BEND BLVD
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23836-2698
Mailing Address - Country:US
Mailing Address - Phone:804-530-2109
Mailing Address - Fax:804-530-1424
Practice Address - Street 1:204 RIVERS BEND BLVD
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:VA
Practice Address - Zip Code:23836-2698
Practice Address - Country:US
Practice Address - Phone:804-530-2109
Practice Address - Fax:804-530-1424
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-16
Last Update Date:2009-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies