Provider Demographics
NPI:1780620617
Name:MEDVENTURES,LLC
Entity type:Organization
Organization Name:MEDVENTURES,LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:GLADYS
Authorized Official - Middle Name:ESTHER
Authorized Official - Last Name:ZAPATA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-883-9675
Mailing Address - Street 1:524 TURNER ST
Mailing Address - Street 2:
Mailing Address - City:THOMASVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27360-2646
Mailing Address - Country:US
Mailing Address - Phone:336-475-2000
Mailing Address - Fax:336-475-2008
Practice Address - Street 1:524 TURNER ST
Practice Address - Street 2:
Practice Address - City:THOMASVILLE
Practice Address - State:NC
Practice Address - Zip Code:27360-2646
Practice Address - Country:US
Practice Address - Phone:336-475-2000
Practice Address - Fax:336-475-2008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty