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Contact Information

FAMILY MEDICAL SUPPLY LLC
4600 MAIN ST STE 12
SHALLOTTE, NC28470-1899
 Phone: 910-755-7066
 Fax: 910-755-7068
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Oxygen Equipment & Supplies

332BX2000X B1 Oxygen supplier
 

Customized Equipment

332BC3200X 87 All Other Suppliers
 

Durable Medical Equipment & Medical Supplies

332B00000X 54 Other Medical Supply Company
 

Parenteral & Enteral Nutrition

332BP3500X 87 All Other Suppliers
Indicates primary specialty

NPI Profile & details for FAMILY MEDICAL SUPPLY LLC

NPI # 1003911942
LBN Legal business name FAMILY MEDICAL SUPPLY LLC
Authorized official WENDY RUSSALESI - (CCO)
Entity Organization
Organization subpart 1 No
Enumeration date 09/14/2006
Last updated 10/13/2025 - About 8 months ago
Identifiers
NC License # 00906
NC Other 0490T BCBS PROVIDER NUMBER
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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