Provider Demographics
NPI:1356513543
Name:BETTS MEDICAL SUPPLIES, LLC.
Entity type:Organization
Organization Name:BETTS MEDICAL SUPPLIES, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:FREDRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:BETTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-222-4561
Mailing Address - Street 1:403 FACTORY STREET
Mailing Address - Street 2:SUITE B
Mailing Address - City:SOUTH BOSTON
Mailing Address - State:VA
Mailing Address - Zip Code:24592
Mailing Address - Country:US
Mailing Address - Phone:434-222-4561
Mailing Address - Fax:
Practice Address - Street 1:403 FACTORY STREET
Practice Address - Street 2:SUITE B
Practice Address - City:SOUTH BOSTON
Practice Address - State:VA
Practice Address - Zip Code:24592
Practice Address - Country:US
Practice Address - Phone:434-222-4561
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-27
Last Update Date:2008-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies