Provider Demographics
NPI:1467620344
Name:PORTERLEWIS, INC.
Entity Type:Organization
Organization Name:PORTERLEWIS, INC.
Other - Org Name:P & L TOTAL MOBILITY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT OF OPERATIONS
Authorized Official - Prefix:MS
Authorized Official - First Name:ANN
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:HOLLAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-762-1744
Mailing Address - Street 1:3865 US HIGHWAY 421 N
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28401-9025
Mailing Address - Country:US
Mailing Address - Phone:910-431-7936
Mailing Address - Fax:910-452-2701
Practice Address - Street 1:3865 US HIGHWAY 421 N
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-9025
Practice Address - Country:US
Practice Address - Phone:910-761-1744
Practice Address - Fax:910-762-1788
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-13
Last Update Date:2008-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7795302Medicaid