Organization
WAKE MEDICAL SUPPLY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORANNYI TAVERAZ (PRESIDENT)
(919) 357-4555
Entity
Organization
Contact information
Practice address
1100 NAVAHO DR STE 122, RALEIGH, NC 27609-7359
(919) 357-4555
(984) 202-2224
Mailing address
1100 NAVAHO DR STE 122, RALEIGH, NC 27609-7359
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
04/30/2022
Last updated
04/15/2024
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