Organization
SALEM MEDICAL SUPPLY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK OKECHUKWU UBABUIKE (MGR)
(336) 896-0503
Entity
Organization
Contact information
Practice address
4265 BROWNSBORO RD, SUITE 240, WINSTON-SALEM, NC 27106
(336) 896-0503
(336) 896-0603
Mailing address
4265 BROWNSBORO RD, SUITE 240, WINSTON-SALEM, NC 27106
(336) 896-0503
(336) 896-0603
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
046VJ
BCBS OF NC
NC
01
—
050447050
TRICARE
—
05
—
7703783
—
NC
01
—
806920
PARTNERS
—
Enumeration date
09/06/2006
Last updated
05/27/2015
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