Provider Demographics
NPI:1942631437
Name:SALES, AVERY
Entity type:Individual
Prefix:MR
First Name:AVERY
Middle Name:
Last Name:SALES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1251 ARROW PINE DR STE A
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28273-5576
Mailing Address - Country:US
Mailing Address - Phone:704-900-5453
Mailing Address - Fax:704-716-3686
Practice Address - Street 1:1251 ARROW PINE DR STE A
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28273-5576
Practice Address - Country:US
Practice Address - Phone:704-900-5453
Practice Address - Fax:704-716-3686
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-09
Last Update Date:2025-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies