| NPI | 1730124363 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERYL W. PHILLIPS V. Pres 803-939-0086 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: SC none required in SC) |
| Additional Taxonomies | 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition (Licence: SC not required in SC) |
| 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies (Licence: SC 65004626) | |
| 335E00000X Prosthetic/Orthotic Supplier (Licence: SC not required in SC) | |
| Enumeration Date | 2006-06-18 |
| Last Update Date | 2020-08-22 |