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Organization

SOUTHERN MEDICAL SUPPLY CO

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. JENNIFER LEE SORENSEN (PRESIDENT)
(919) 876-5522
Entity
Organization

Contact information

Practice address
5009 DEVONWOOD CT, RALEIGH, NC 27609
(919) 876-5522
(919) 876-9435
Mailing address
PO BOX 99307, RALEIGH, NC 27624-9307
(919) 876-5522
(919) 876-9435

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
A259257
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0494V
BCBS OF NC
NC
01
153146800
US DEPT LABOR ACS
NC
05
7700411
NC
Enumeration date
11/13/2006
Last updated
06/13/2008
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