Provider Demographics
NPI:1275845612
Name:MEDACTIVE, LLC.
Entity Type:Organization
Organization Name:MEDACTIVE, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:GREENWAY
Authorized Official - Last Name:TURPIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-302-4876
Mailing Address - Street 1:2228 PAGE RD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-7932
Mailing Address - Country:US
Mailing Address - Phone:919-302-4876
Mailing Address - Fax:919-800-3347
Practice Address - Street 1:2228 PAGE RD
Practice Address - Street 2:SUITE 107
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27703-7932
Practice Address - Country:US
Practice Address - Phone:919-302-4876
Practice Address - Fax:919-800-3347
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-13
Last Update Date:2010-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies