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
Update your record
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