Provider Demographics
NPI:1518054774
Name:CW MEDICAL INC
Entity Type:Organization
Organization Name:CW MEDICAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:GAIL
Authorized Official - Middle Name:M
Authorized Official - Last Name:CHAPMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-849-0128
Mailing Address - Street 1:PO BOX 2090
Mailing Address - Street 2:714-C CAROLINA AVE
Mailing Address - City:YADKINVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27055-2090
Mailing Address - Country:US
Mailing Address - Phone:336-849-0128
Mailing Address - Fax:336-849-0130
Practice Address - Street 1:714 CAROLINA AVE # C
Practice Address - Street 2:SUITE C
Practice Address - City:YADKINVILLE
Practice Address - State:NC
Practice Address - Zip Code:27055-7760
Practice Address - Country:US
Practice Address - Phone:336-849-0128
Practice Address - Fax:336-849-0130
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1205620001OtherPTAN
NC7702204Medicaid