Provider Demographics
NPI:1770992307
Name:NEXGEN MEDICAL LLC
Entity type:Organization
Organization Name:NEXGEN MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:M
Authorized Official - Last Name:SHAFFER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-497-1410
Mailing Address - Street 1:191 KNOXVIEW LN
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117-7554
Mailing Address - Country:US
Mailing Address - Phone:571-214-7530
Mailing Address - Fax:704-413-3329
Practice Address - Street 1:191 KNOXVIEW LN
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28117-7554
Practice Address - Country:US
Practice Address - Phone:571-214-7530
Practice Address - Fax:704-413-3329
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-07
Last Update Date:2014-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies