Organization
DAVIE MEDICAL EQUIPMENT INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GERALD THOMAS MCMILLAN RRT,RCP (PRESIDENT/OWNER)
(336) 751-4288
Entity
Organization
Contact information
Practice address
959 SALISBURY RD, MOCKSVILLE, NC 27028-9301
(336) 751-4288
Mailing address
959 SALISBURY RD, MOCKSVILLE, NC 27028-9301
(336) 751-4288
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
HC1590
NC
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
HC1590
NC
332BX2000X
Oxygen Equipment & Supplies (DME)
HC1590
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0421L
BCBS
NC
01
—
13742
PARTNERS
NC
01
—
36198
WELLPATH
NC
05
—
7701586
—
NC
Enumeration date
12/07/2005
Last updated
07/11/2013
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