1003651894 NPI number — NINE-TO-FIVE MEDICAL SUPPLY LLC

Table of content: CHUKWUKELUE NWABUEZE UCHEFUNA MD (NPI 1407683899)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003651894 NPI number — NINE-TO-FIVE MEDICAL SUPPLY LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NINE-TO-FIVE MEDICAL SUPPLY LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1003651894
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/25/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
86 OLD ROBERTS RD STE 103A
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BENSON
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27504-8721
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
919-893-4800
Provider Business Mailing Address Fax Number:
919-893-4800

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
86 OLD ROBERTS RD STE 103A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BENSON
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27504-8721
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-893-4800
Provider Business Practice Location Address Fax Number:
919-893-4800
Provider Enumeration Date:
06/25/2024

Additional Information

Authorized Official

Authorized Official Last Name:
ANAGBOGU
Authorized Official First Name:
MARTYN
Authorized Official Middle Name:
CHUKWUMA
Authorized Official Title or Position:
MANAGING DIRECTOR
Authorized Official Telephone Number:
919-332-9404

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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