Organization
A&W EXPRESS INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. AVERY WINDER (PRESIDENT)
(704) 488-7784
Entity
Organization
Contact information
Practice address
4623 POTTERS GLEN RD, CHARLOTTE, NC 28269-7351
(704) 488-7784
(704) 599-5876
Mailing address
4623 POTTERS GLEN RD, CHARLOTTE, NC 28269-7351
(704) 488-7784
(704) 599-5876
Taxonomy
Speciality
Code
Description
License number
State
332BN1400X
Nursing Facility Supplies (DME)
Primary
21068639
NC
Other
Enumeration date
10/02/2009
Last updated
10/02/2009
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