Provider Demographics
NPI:1841356904
Name:LUMPKIN, CAROLYN HOLLAND (CERTIFIED FITTER)
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:HOLLAND
Last Name:LUMPKIN
Suffix:
Gender:F
Credentials:CERTIFIED FITTER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:625 PINEY FOREST RD STE 202
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24540
Mailing Address - Country:US
Mailing Address - Phone:434-793-5239
Mailing Address - Fax:434-793-5240
Practice Address - Street 1:625 PINEY FOREST RD STE 202
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24540
Practice Address - Country:US
Practice Address - Phone:434-793-5239
Practice Address - Fax:434-793-5240
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-30
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1299060001OtherPALMETTO
VA1299060001OtherPALMETTO