Provider Demographics
NPI:1326191545
Name:R AND R IN BELHAVEN LLC
Entity Type:Organization
Organization Name:R AND R IN BELHAVEN LLC
Other - Org Name:BELHAVEN MEDICAL SUPPLY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:REX
Authorized Official - Last Name:CARRAWAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-945-0891
Mailing Address - Street 1:PO BOX 549
Mailing Address - Street 2:
Mailing Address - City:BELHAVEN
Mailing Address - State:NC
Mailing Address - Zip Code:27810-0549
Mailing Address - Country:US
Mailing Address - Phone:252-945-0891
Mailing Address - Fax:
Practice Address - Street 1:467 PAMLICO ST
Practice Address - Street 2:
Practice Address - City:BELHAVEN
Practice Address - State:NC
Practice Address - Zip Code:27810-1421
Practice Address - Country:US
Practice Address - Phone:252-945-0891
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-19
Last Update Date:2008-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC01248332BD1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BD1200XSuppliersDurable Medical Equipment & Medical SuppliesDialysis Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC01248OtherN.C.BORD OF PHARMACE
NC5903710001Medicare NSC