Organization
TOP FORM INC.
Active
Other names
Top Form d/b/a A 2 Z Home Medical Supplies
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARTIN GALLAN (CEO)
(910) 484-0567
Entity
Organization
Contact information
Practice address
1708A OWEN DRIVE, FAYETTEVILLE, NC 28304
(910) 484-0567
(910) 484-2692
Mailing address
P O BOX 1594, WILMINGTON, NC 28402
(910) 392-5553
(910) 202-3236
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
08/29/2006
Last updated
08/22/2020
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