Organization Name: | WAKE SPECIALTY PHYSICIANS LLC |
NPI Number: | 1093184368 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MARIA JAYOUSSI (EXECUTIVE DIRECTOR FINANCE) |
Mailing Address: | 400 Us Highway 70 East Suite 202 Garner |
State: | NC US |
Postal Code: | 275294049 |
Phone Number: | 9192325020 |
Fax Number: | 9192325021 |
NPI Enumeration Date: | 09/17/2015 |
NPI Last Update Date: | 12/31/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | |
Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |