Provider Demographics
NPI:1336393339
Name:CADMUS, SHEILA LOUISE (LPN, CFT, ADM)
Entity Type:Individual
Prefix:MRS
First Name:SHEILA
Middle Name:LOUISE
Last Name:CADMUS
Suffix:
Gender:F
Credentials:LPN, CFT, ADM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 1102
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27889-3571
Mailing Address - Country:US
Mailing Address - Phone:252-975-1358
Mailing Address - Fax:252-975-1659
Practice Address - Street 1:1201 CAROLINA AVE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:NC
Practice Address - Zip Code:27889-3571
Practice Address - Country:US
Practice Address - Phone:252-975-1358
Practice Address - Fax:252-975-1659
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-05
Last Update Date:2008-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCCFTS0236332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7704691Medicaid
NC7704691Medicaid