Organization
MISSION MEDICAL SUPPLY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENNETH EUGENE BROWN (PRESIDENT)
(704) 489-6360
Entity
Organization
Contact information
Practice address
1897 NORTH HWY 16, DENVER, NC 28037
(704) 489-6362
(704) 489-6360
Mailing address
1897 NORTH HWY 16, DENVER, NC 28037
(704) 489-6362
(704) 489-6360
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
00921
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7704018
—
NC
Enumeration date
01/17/2006
Last updated
08/22/2020
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