1952512352 NPI number — FAITH MEDICAL SUPPLIES

Table of content: (NPI 1952512352)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952512352 NPI number — FAITH MEDICAL SUPPLIES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FAITH MEDICAL SUPPLIES
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:
1952512352
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
306 A WEST BROAD STREET
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ST PAULS
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28384
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
910-865-3452
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
306 W BROAD ST
Provider Second Line Business Practice Location Address:
SUITE A
Provider Business Practice Location Address City Name:
SAINT PAULS
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28384-1536
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-865-3452
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/25/2007

Additional Information

Authorized Official

Authorized Official Last Name:
SINGLETON
Authorized Official First Name:
MINNIE
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
910-474-2932

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: 3408352 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 6601246 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com