Provider Demographics
NPI:1225447980
Name:MEDPARTNERS, CORP.
Entity Type:Organization
Organization Name:MEDPARTNERS, CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PHIL
Authorized Official - Middle Name:D
Authorized Official - Last Name:BLAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-283-2728
Mailing Address - Street 1:450 AIRPORT RD
Mailing Address - Street 2:STE 2
Mailing Address - City:FLETCHER
Mailing Address - State:NC
Mailing Address - Zip Code:28732-6712
Mailing Address - Country:US
Mailing Address - Phone:888-572-3330
Mailing Address - Fax:888-579-6040
Practice Address - Street 1:450 AIRPORT RD
Practice Address - Street 2:STE 2
Practice Address - City:FLETCHER
Practice Address - State:NC
Practice Address - Zip Code:28732-6712
Practice Address - Country:US
Practice Address - Phone:888-572-3330
Practice Address - Fax:888-579-6040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-07
Last Update Date:2017-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC02197332B00000X, 332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1225447980Medicaid
NC1225447980Medicaid