Organization
SCOG HOME MEDICAL SUPPLY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OZENIM PAUL IGUMBOR (CEO)
(770) 557-9921
Entity
Organization
Contact information
Practice address
9635 SOUTHERN PINE BLVD STE 110, CHARLOTTE, NC 28273-5545
(980) 224-9000
(980) 224-7222
Mailing address
16139 STUARTS DRAFT CT, CHARLOTTE, NC 28278-7278
(770) 557-9921
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
332BC3200X
Customized Equipment (DME)
—
—
332BD1200X
Dialysis Equipment & Supplies (DME)
—
—
332BN1400X
Nursing Facility Supplies (DME)
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
—
—
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Enumeration date
03/14/2022
Last updated
04/19/2023
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