Organization
MS LOLA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LOLA ORTIZ (OWNER)
(252) 337-9844
Entity
Organization
Contact information
Practice address
1113 N ROAD ST, ELIZABETH CITY, NC 27909-3334
(252) 337-9844
(252) 337-9845
Mailing address
1113 N ROAD STREET, ELIZABETH CITY, NC 27909-3334
(252) 337-9844
(252) 337-9845
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
06/15/2011
Last updated
06/15/2011
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