Organization
ACTIVE MEDICAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JENNIFER LYNNE WHITLEY (ACCOUNTING)
(919) 496-7362
Entity
Organization
Contact information
Practice address
108 N MAIN ST, LOUISBURG, NC 27549-2516
(919) 496-7362
(919) 496-6379
Mailing address
108 N MAIN ST, LOUISBURG, NC 27549-2516
(919) 496-7362
(919) 496-6379
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7702540
—
NC
Enumeration date
02/23/2006
Last updated
08/22/2020
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