Provider Demographics
NPI:1407860083
Name:CORE MEDICAL SUPPLIES, INC.
Entity Type:Organization
Organization Name:CORE MEDICAL SUPPLIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BEVERLY
Authorized Official - Middle Name:A
Authorized Official - Last Name:HEITMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-248-3700
Mailing Address - Street 1:PO BOX 608
Mailing Address - Street 2:
Mailing Address - City:THOMASVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27361-0608
Mailing Address - Country:US
Mailing Address - Phone:336-248-3700
Mailing Address - Fax:
Practice Address - Street 1:218 ANNA LEWIS DR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:NC
Practice Address - Zip Code:27292-6711
Practice Address - Country:US
Practice Address - Phone:336-248-3700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC00537332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7703274Medicaid
3910720001Medicare ID - Type Unspecified