Elegant Profile LLC
Durable Medical Equipment & Medical Supplies in Winston Salem, NC. Organization (NPI-2).
NPI number1194586115
StatusActive
Last updated in NPPESApr 21, 2025
Details
- NPI
- 1194586115
- Entity type
- Organization (NPI-2)
- Legal business name
- Elegant Profile LLC
- Organization subpart
- No
- Enumeration date
- Jan 17, 2024
- Certification date
- Apr 21, 2025
- Last updated
- Apr 21, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 332B00000X | Durable Medical Equipment & Medical Supplies | – | – | Yes |
| 224900000X | Mastectomy Fitter | – | – |
Practice location
4622 Country Club Rd Ste 100Winston Salem, NC 27104-3770
Phone 336-331-3480 · Fax 336-793-1218
Mailing address
4622 Country Club Rd Ste 100Winston Salem, NC 27104-3770
Phone 336-331-3480 · Fax 336-793-1218
Authorized official
Justine Juchter
Vice President
3363313480
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