Organization
SUSAN CORNELIA RICE FAISON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SUSAN CORNELIA RICE FAISON (OWNER)
(434) 577-2780
Entity
Organization
Contact information
Practice address
724 PARADISE DR, VALENTINES, VA 23887
(434) 577-2780
(434) 577-3023
Mailing address
PO BOX 60, VALENTINES, VA 23887-0060
(434) 577-2780
(434) 577-3023
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
NONE
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7703383
—
NC
05
—
9120955
—
VA
Enumeration date
08/18/2006
Last updated
09/04/2008
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