Provider Demographics
NPI:1184627812
Name:CVC HOME MEDICAL, INC.
Entity Type:Organization
Organization Name:CVC HOME MEDICAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GARLAND
Authorized Official - Middle Name:WASHINGTON
Authorized Official - Last Name:SEWELL
Authorized Official - Suffix:JR
Authorized Official - Credentials:RPH
Authorized Official - Phone:910-326-3349
Mailing Address - Street 1:PO BOX 10731
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28404-0731
Mailing Address - Country:US
Mailing Address - Phone:910-686-3599
Mailing Address - Fax:910-686-3499
Practice Address - Street 1:8114 MARKET ST
Practice Address - Street 2:STE 100
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28411-9386
Practice Address - Country:US
Practice Address - Phone:910-686-3599
Practice Address - Fax:910-686-3499
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-27
Last Update Date:2012-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC694332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7703707Medicaid
NC1060010003Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER