Mutual Medical, LLC

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

Legal business name

MUTUAL MEDICAL, LLC

Practice address

108 Sharon Dr
Yadkinville, NC 27055-6769

Phone

(336) 677-1299

Fax

(336) 677-1219

NPI assigned

Mar 17, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. A Blake Abbott

Title

Partner

Phone

(336) 677-1299

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1205712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228176000000",
    "number": "1891966073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1426",
            "city": "YADKINVILLE",
            "state": "NC",
            "postal_code": "270551426",
            "telephone_number": "336-677-1299",
            "fax_number": "336-677-1219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 SHARON DR",
            "city": "YADKINVILLE",
            "state": "NC",
            "postal_code": "270556769",
            "telephone_number": "336-677-1299",
            "fax_number": "336-677-1219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MUTUAL MEDICAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-17",
        "last_updated": "2008-12-02",
        "status": "A",
        "authorized_official_last_name": "ABBOTT",
        "authorized_official_first_name": "A",
        "authorized_official_middle_name": "BLAKE",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "336-677-1299",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7704965",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Customized Equipment (DME) in Yadkinville, NC
• Providers in Yadkinville, NC by specialty
• Customized Equipment (DME) in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.