Provider Demographics
NPI:1659970770
Name:SURVIVOR FRIENDLY LLC
Entity Type:Organization
Organization Name:SURVIVOR FRIENDLY LLC
Other - Org Name:MANELINES UNIQUE BOUTIQUE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:CROMITY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-394-7456
Mailing Address - Street 1:527 KEISLER DR STE 104
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27518-9306
Mailing Address - Country:US
Mailing Address - Phone:919-394-7456
Mailing Address - Fax:
Practice Address - Street 1:527 KEISLER DR STE 104
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27518-9306
Practice Address - Country:US
Practice Address - Phone:919-474-9336
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-20
Last Update Date:2021-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Yes332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment