Provider Demographics
NPI:1740618792
Name:SYNERGY MEDICAL SUPPLY
Entity Type:Organization
Organization Name:SYNERGY MEDICAL SUPPLY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:
Authorized Official - First Name:ZANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-728-0214
Mailing Address - Street 1:PO BOX 480448
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28269-5320
Mailing Address - Country:US
Mailing Address - Phone:704-728-0214
Mailing Address - Fax:888-461-3210
Practice Address - Street 1:1931 J N PEASE PL STE 101
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-4540
Practice Address - Country:US
Practice Address - Phone:704-728-0214
Practice Address - Fax:888-461-3210
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-29
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies