| NPI | 1962576165 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MILDRED T TISDALE Ins Claims Admin 803-564-5340 |
| Organization Subpart ? | No |
| Primary Taxonomy | 237700000X Hearing Instrument Specialist |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: GA 643) |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2022-09-06 |