Provider Demographics
NPI:1922237510
Name:FANARY, DEBBIE C
Entity Type:Individual
Prefix:
First Name:DEBBIE
Middle Name:C
Last Name:FANARY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3003
Mailing Address - Street 2:
Mailing Address - City:THOMASVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27361-3003
Mailing Address - Country:US
Mailing Address - Phone:336-240-2759
Mailing Address - Fax:
Practice Address - Street 1:995 BLACK LAKE RD
Practice Address - Street 2:
Practice Address - City:THOMASVILLE
Practice Address - State:NC
Practice Address - Zip Code:27360-9090
Practice Address - Country:US
Practice Address - Phone:336-240-2759
Practice Address - Fax:336-475-2005
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-06
Last Update Date:2009-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)