Organization
FAMILY MEDICAL SUPPLY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WENDY RUSSALESI (CCO)
(484) 246-9499
Entity
Organization
Contact information
Practice address
2005 W CUMBERLAND ST, DUNN, NC 28334-4447
(910) 892-3432
Mailing address
555 E NORTH LN STE 5075, CONSHOHOCKEN, PA 19428-2490
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BC3200X
Customized Equipment (DME)
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
00060
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0490T
BCBS PROVIDER NUMBER
NC
Enumeration date
08/30/2006
Last updated
01/12/2026
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