Provider Demographics
NPI:1184914558
Name:BROOKINS INC.
Entity type:Organization
Organization Name:BROOKINS INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:BROOKINS
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:704-735-2556
Mailing Address - Street 1:626 CENTER DR
Mailing Address - Street 2:
Mailing Address - City:LINCOLNTON
Mailing Address - State:NC
Mailing Address - Zip Code:28092-3712
Mailing Address - Country:US
Mailing Address - Phone:704-735-2556
Mailing Address - Fax:704-735-9045
Practice Address - Street 1:626 CENTER DR
Practice Address - Street 2:
Practice Address - City:LINCOLNTON
Practice Address - State:NC
Practice Address - Zip Code:28092-3712
Practice Address - Country:US
Practice Address - Phone:704-735-2556
Practice Address - Fax:704-735-9045
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-19
Last Update Date:2011-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5910332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7701534Medicaid
0996620001Medicare NSC