Provider Demographics
NPI:1932366192
Name:R AND R IN BELHAVEN, LLC
Entity Type:Organization
Organization Name:R AND R IN BELHAVEN, LLC
Other - Org Name:BELHAVEN MEDICAL SUPPLY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:REX
Authorized Official - Last Name:CARRAWAY
Authorized Official - Suffix:
Authorized Official - Credentials:CFST
Authorized Official - Phone:252-943-3104
Mailing Address - Street 1:467 PAMLICO ST
Mailing Address - Street 2:PO BOX 549
Mailing Address - City:BELHAVEN
Mailing Address - State:NC
Mailing Address - Zip Code:27810-1421
Mailing Address - Country:US
Mailing Address - Phone:252-943-3104
Mailing Address - Fax:252-943-3111
Practice Address - Street 1:467 PAMLICO ST
Practice Address - Street 2:
Practice Address - City:BELHAVEN
Practice Address - State:NC
Practice Address - Zip Code:27810-1421
Practice Address - Country:US
Practice Address - Phone:252-943-3104
Practice Address - Fax:252-943-3111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-16
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7795362Medicaid
NC7795362Medicaid