Provider Demographics
NPI:1902123755
Name:PRO-MED EQUIPMENT AND SUPPLY, INC
Entity Type:Organization
Organization Name:PRO-MED EQUIPMENT AND SUPPLY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELVIN
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:CHAMBLEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-332-8081
Mailing Address - Street 1:601 E MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:AHOSKIE
Mailing Address - State:NC
Mailing Address - Zip Code:27910-3935
Mailing Address - Country:US
Mailing Address - Phone:252-332-8081
Mailing Address - Fax:252-332-8091
Practice Address - Street 1:514 EAST BLVD
Practice Address - Street 2:
Practice Address - City:WILLIAMSTON
Practice Address - State:NC
Practice Address - Zip Code:27892-2734
Practice Address - Country:US
Practice Address - Phone:252-792-0007
Practice Address - Fax:252-792-0004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-03
Last Update Date:2010-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies