Provider Demographics
NPI:1174000814
Name:AMAZION HEALTHCARE & MEDICAL SUPPLY INC
Entity Type:Organization
Organization Name:AMAZION HEALTHCARE & MEDICAL SUPPLY INC
Other - Org Name:AMAZION HEALTHCARE & MEDICAL SUPPLY INC
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAMIAN
Authorized Official - Middle Name:CHIBUEZE
Authorized Official - Last Name:OGBAUGO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-560-9377
Mailing Address - Street 1:704C PLAZA BLVD STE 112
Mailing Address - Street 2:
Mailing Address - City:KINSTON
Mailing Address - State:NC
Mailing Address - Zip Code:28501-1560
Mailing Address - Country:US
Mailing Address - Phone:252-560-9377
Mailing Address - Fax:
Practice Address - Street 1:3215 JENNIFER LN
Practice Address - Street 2:
Practice Address - City:KINSTON
Practice Address - State:NC
Practice Address - Zip Code:28504-1211
Practice Address - Country:US
Practice Address - Phone:252-560-9377
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-25
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care