1578593554 NPI number — ANCHOR MEDICAL SUPPLIES & EQUIPMENT

Table of content: (NPI 1578593554)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1578593554 NPI number — ANCHOR MEDICAL SUPPLIES & EQUIPMENT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ANCHOR MEDICAL SUPPLIES & EQUIPMENT
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:
6
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:
1578593554
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/17/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 410683
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHARLOTTE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28241-0683
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
704-588-5288
Provider Business Mailing Address Fax Number:
704-588-5288

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
218 WESTINGHOUSE BLVD
Provider Second Line Business Practice Location Address:
SUITE 202
Provider Business Practice Location Address City Name:
CHARLOTTE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28273-6241
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
704-588-5288
Provider Business Practice Location Address Fax Number:
704-588-0663
Provider Enumeration Date:
07/04/2006

Additional Information

Authorized Official

Authorized Official Last Name:
EYO
Authorized Official First Name:
JOSEPH
Authorized Official Middle Name:
EDET
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
704-588-5288

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)

  • Identifier: 7703834 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: DE2363 , issued by the state of ( SC ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com