Provider Demographics
NPI:1396039731
Name:MED-CARE EQUIPMENT & SUPPLIES, LLC
Entity type:Organization
Organization Name:MED-CARE EQUIPMENT & SUPPLIES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COMPLIANCE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:TEE
Authorized Official - Middle Name:
Authorized Official - Last Name:FERGUSON
Authorized Official - Suffix:SR
Authorized Official - Credentials:JD
Authorized Official - Phone:252-332-3600
Mailing Address - Street 1:PO BOX 741
Mailing Address - Street 2:
Mailing Address - City:AHOSKIE
Mailing Address - State:NC
Mailing Address - Zip Code:27910-0741
Mailing Address - Country:US
Mailing Address - Phone:252-332-3600
Mailing Address - Fax:252-332-3611
Practice Address - Street 1:201 RAILROAD ST N
Practice Address - Street 2:
Practice Address - City:AHOSKIE
Practice Address - State:NC
Practice Address - Zip Code:27910-3042
Practice Address - Country:US
Practice Address - Phone:252-332-3600
Practice Address - Fax:252-332-3611
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-02
Last Update Date:2011-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC01762332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
6544880001Medicare NSC