Organization
RANDYS MOM LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIA SIMMONS (OWNER)
(919) 757-6844
Entity
Organization
Contact information
Practice address
515 KEISLER DR STE 102, CARY, NC 27518-7097
(919) 757-6844
(919) 230-2510
Mailing address
515 KEISLER DR STE 102, CARY, NC 27518-7097
(919) 757-6844
(919) 230-2510
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
Other
Enumeration date
09/24/2015
Last updated
09/24/2015
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