Basic Information
| Provider Information | |||||||||
| NPI: | 1275520140 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CHAIR & EQUIPMENT RENTALS AND SALES | ||||||||
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| Mailing Information | |||||||||
| Address1: | 800 CENTRAL AVE | ||||||||
| Address2: | |||||||||
| City: | CHARLOTTE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 282042026 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7043338431 | ||||||||
| FaxNumber: | 7043335506 | ||||||||
| Practice Location | |||||||||
| Address1: | 800 CENTRAL AVE | ||||||||
| Address2: | |||||||||
| City: | CHARLOTTE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 282042026 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7043338431 | ||||||||
| FaxNumber: | 7043335506 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/05/2005 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | DOLAN | ||||||||
| AuthorizedOfficialFirstName: | WILLIAM | ||||||||
| AuthorizedOfficialMiddleName: | C | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 7043338431 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332BC3200X | 73 | NC | Y | Suppliers | Durable Medical Equipment & Medical Supplies | Customized Equipment |
ID Information
| ID | Type | State | Issuer | Description | 32 CHAIR & EQUPIMENT | 01 | GENTIVA CARECENTRIX | OTHER | CHAIR & EQUIPMENT | 01 | PROCURA | OTHER | 7701460 | 05 | NC | MEDICAID | CHAIR & EQUIPMENT | 01 | PROGRESSIVE | OTHER | 18538 | 01 | PARTNERS MEDICARE | OTHER | 046AK | 01 | BLUE CROSS BLUE SHIELD | OTHER | CHAIR & EQUIPMENT | 01 | MSC MEDICAL SERVICES COMP | OTHER | DME857 | 05 | SC | MEDICAID |