Provider Demographics
NPI:1356614572
Name:DESIGN MEDICAL INDUSTRY
Entity type:Organization
Organization Name:DESIGN MEDICAL INDUSTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:MS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:A
Authorized Official - Last Name:KLUTTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-750-9335
Mailing Address - Street 1:216 COGGINS AVE
Mailing Address - Street 2:
Mailing Address - City:ALBEMARLE
Mailing Address - State:NC
Mailing Address - Zip Code:28001-5118
Mailing Address - Country:US
Mailing Address - Phone:704-750-9335
Mailing Address - Fax:877-239-8685
Practice Address - Street 1:216 COGGINS AVE
Practice Address - Street 2:
Practice Address - City:ALBEMARLE
Practice Address - State:NC
Practice Address - Zip Code:28001-5118
Practice Address - Country:US
Practice Address - Phone:704-750-9335
Practice Address - Fax:877-239-8685
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-18
Last Update Date:2012-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies