Provider Demographics
NPI:1962470351
Name:DSF OF PREFERENCE
Entity Type:Organization
Organization Name:DSF OF PREFERENCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:MCGEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-992-0100
Mailing Address - Street 1:PO BOX 26565
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28221-6565
Mailing Address - Country:US
Mailing Address - Phone:704-992-0100
Mailing Address - Fax:704-393-0913
Practice Address - Street 1:107 S OLD STATESVILLE RD
Practice Address - Street 2:STE 7
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078
Practice Address - Country:US
Practice Address - Phone:704-992-0100
Practice Address - Fax:704-393-0913
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7701953Medicaid
NV0226408000Medicaid
NC0467AOtherBCBS
NV0226408000Medicaid