Provider Demographics
NPI:1487960076
Name:MED CONN
Entity type:Organization
Organization Name:MED CONN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MIA
Authorized Official - Middle Name:PARKER
Authorized Official - Last Name:HEDSPETH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-862-1041
Mailing Address - Street 1:1112 N ACADEMY ST
Mailing Address - Street 2:
Mailing Address - City:AHOSKIE
Mailing Address - State:NC
Mailing Address - Zip Code:27910-0485
Mailing Address - Country:US
Mailing Address - Phone:252-862-1041
Mailing Address - Fax:252-862-1043
Practice Address - Street 1:1112 ACADEMY ST N
Practice Address - Street 2:
Practice Address - City:AHOSKIE
Practice Address - State:NC
Practice Address - Zip Code:27910-2210
Practice Address - Country:US
Practice Address - Phone:252-862-1041
Practice Address - Fax:252-862-1043
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-20
Last Update Date:2010-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC00329332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies