Organization
NEVAEH & COMPANY LLC
Active
Other names
RESTORATIVE MEDICAL
Organization subpart
No
Provider details
NPI number
Authorized official
RANDY WOOD (OFFICE MANAGER)
(904) 806-2936
Entity
Organization
Contact information
Practice address
2491 ARMSTRONG DR, WINSTON SALEM, NC 27103-6813
(336) 776-1599
(336) 661-9378
Mailing address
2491 ARMSTRONG DR, WINSTON SALEM, NC 27103-6813
(336) 776-1599
(336) 661-9378
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
00310
NC
332BC3200X
Customized Equipment (DME)
Primary
00310
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3405962
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
09/07/2005
Last updated
04/10/2017
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