Organization
SOUTH EASTERN MEDICAL SUPLIES,INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EZUMA E ASI RN (DIRECTOR)
(919) 341-4468
Entity
Organization
Contact information
Practice address
1307 E MILLBROOK RD, SUITE C-23, RALEIGH, NC 27609-5476
(919) 341-4468
(919) 341-2378
Mailing address
1307 E MILLBROOK RD, SUITE C-23, RALEIGH, NC 27609-5476
(919) 341-4468
(919) 341-2378
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
01375
NC
332BC3200X
Customized Equipment (DME)
01375
NC
332BN1400X
Nursing Facility Supplies (DME)
01375
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01375
NC BOARD OF PHARMACY
NC
Enumeration date
01/06/2008
Last updated
04/23/2008
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