Provider Demographics
NPI:1942422258
Name:D&L FERGUSON, LLC
Entity Type:Organization
Organization Name:D&L FERGUSON, LLC
Other - Org Name:CREATE A ROOM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:
Authorized Official - Last Name:WICINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-264-0661
Mailing Address - Street 1:110 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:WINTERSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43953
Mailing Address - Country:US
Mailing Address - Phone:740-264-6440
Mailing Address - Fax:740-264-6855
Practice Address - Street 1:110 MAIN STREET
Practice Address - Street 2:
Practice Address - City:WINTERSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43953
Practice Address - Country:US
Practice Address - Phone:740-264-6440
Practice Address - Fax:740-264-6855
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies