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Individual

SHELLEY PHILLIPS BANDY

Active
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Individual

SHELLEY PHILLIPS BANDY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CMF,CMF,COF

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
C51438
NC
332BC3200X
Customized Equipment (DME)
C51438
NC
332BD1200X
Dialysis Equipment & Supplies (DME)
C51438
NC
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
C51438
NC
332BX2000X
Oxygen Equipment & Supplies (DME)
C51438
NC
335E00000X
Prosthetic/Orthotic Supplier
Primary
C51438
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1295280139
BLUE CROSS AND BLUE SHIELD NC
NC
05
1295280139
NC
Enumeration date
10/09/2014
Last updated
02/10/2017
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