Organization
SPIC MEDICAL EQUIPMENT SUPPLY
Active
Parent organization
SERENITY PLACE INTERVENTION CENTER INC
Other names
SPIC MEDICAL EQUIPMENT SUPPLY, Serenity Place Intervention Center Inc
Organization subpart
Yes
Provider details
NPI number
Legal business name
SERENITY PLACE INTERVENTION CENTER INC
Authorized official
MR. PETER ONUZULIKE SR. MR. (OWNER / PERSON-IN-CHARGE)
(919) 395-5262
Entity
Organization
Contact information
Practice address
140 MINE LAKE CT STE 100, RALEIGH, NC 27615-6417
(919) 395-5262
(919) 518-8295
Mailing address
140 MINE LAKE CT STE 100, RALEIGH, NC 27615-6417
(919) 395-5262
(919) 518-8295
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03163
DME PERMIT
NC
Enumeration date
03/05/2024
Last updated
03/08/2024
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