Provider Demographics
NPI:1023073517
Name:MEADS, SYLVIA S (ROFM)
Entity type:Individual
Prefix:MRS
First Name:SYLVIA
Middle Name:S
Last Name:MEADS
Suffix:
Gender:F
Credentials:ROFM
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 1471
Mailing Address - Street 2:106 MEDICAL DRIVE
Mailing Address - City:ELIZ CITY
Mailing Address - State:NC
Mailing Address - Zip Code:27909
Mailing Address - Country:US
Mailing Address - Phone:252-338-3002
Mailing Address - Fax:252-338-2902
Practice Address - Street 1:106 MEDICAL DRIVE
Practice Address - Street 2:
Practice Address - City:ELIZ CITY
Practice Address - State:NC
Practice Address - Zip Code:27909
Practice Address - Country:US
Practice Address - Phone:252-338-3002
Practice Address - Fax:252-338-2902
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-19
Last Update Date:2013-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCCFOM0204225000000X
NC229N00000X, 332BC3200X
224900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No225000000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotic Fitter
No229N00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersAnaplastologist
No224900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMastectomy Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA384410OtherBCBS
NC7701327Medicaid
NC0482POtherBCBS
7795160OtherINDIVID EDS
VA9190511Medicaid
VA9190511Medicaid