Organization
RALEIGH MEDICAL SUPPLY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CLARENCE EDWARD LUPTON III (OWNER/MANAGER)
(919) 781-2281
Entity
Organization
Contact information
Practice address
2601 BLUE RIDGE RD, RALEIGH, NC 27607-6481
(919) 781-2281
(919) 782-0360
Mailing address
2601 BLUE RIDGE RD, RALEIGH, NC 27607-6481
(919) 781-2281
(919) 782-0360
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
00430
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7702986
—
NC
Enumeration date
07/24/2007
Last updated
07/24/2007
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