Organization
HELEN GORDON
Active
Other names
Cameo Bra Shop
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. HELEN D GORDON MEDICARE PROVIDER DM (OWNER MGR)
(336) 788-3052
Entity
Organization
Contact information
Practice address
3578 HEATHROW DR, WINSTON SALEM, NC 27127-4674
(336) 788-3052
Mailing address
3578 HEATHROW DR, WINSTON SALEM, NC 27127-4674
(336) 788-3052
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0474C
BCBS NC
NC
01
—
2404
PARTNERS
NC
05
—
7701509
—
NC
Enumeration date
11/23/2005
Last updated
07/10/2008
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