Provider Demographics
NPI:1043849219
Name:ABSOLUTE DME
Entity Type:Organization
Organization Name:ABSOLUTE DME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:GARRETT
Authorized Official - Middle Name:
Authorized Official - Last Name:LONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-757-2570
Mailing Address - Street 1:4745 CAMP BETTY HASTINGS RD
Mailing Address - Street 2:
Mailing Address - City:WALKERTOWN
Mailing Address - State:NC
Mailing Address - Zip Code:27051-9133
Mailing Address - Country:US
Mailing Address - Phone:919-744-5720
Mailing Address - Fax:
Practice Address - Street 1:210 N MAIN ST STE 112
Practice Address - Street 2:
Practice Address - City:KERNERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27284-4003
Practice Address - Country:US
Practice Address - Phone:336-757-2750
Practice Address - Fax:336-793-3014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-08
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies