Organization
DIVINE MEDICAL SUPPLIES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. FLORINE FLEMING RN (OWNER)
(910) 904-2377
Entity
Organization
Contact information
Practice address
320 BIRCH ST, RAEFORD, NC 28376
(910) 904-2377
(910) 904-2477
Mailing address
310 BIRCH ST, RAEFORD, NC 28376-3297
(910) 904-2377
(910) 904-2477
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
01700
NC
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
01700
NC
Other
Enumeration date
05/15/2015
Last updated
05/15/2015
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