Provider Demographics
NPI:1881442630
Name:SINCLAIR, AGNUS MIRANDA
Entity type:Individual
Prefix:
First Name:AGNUS
Middle Name:MIRANDA
Last Name:SINCLAIR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:845 HOLLY SWAMP CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:LUMBERTON
Mailing Address - State:NC
Mailing Address - Zip Code:28360-3121
Mailing Address - Country:US
Mailing Address - Phone:910-852-1165
Mailing Address - Fax:
Practice Address - Street 1:845 HOLLY SWAMP CHURCH RD
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:NC
Practice Address - Zip Code:28360-3121
Practice Address - Country:US
Practice Address - Phone:910-852-1165
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-07
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment