MEDICARE: SUMTER MEDICAL SUPPLIES INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1871557439
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUMTER MEDICAL SUPPLIES INC

Provider Business Mailing Address
First Line	:	32 S MAIN ST
Second Line	:	SUITE A
City	:	SUMTER
State	:	SC
Zip	:	29150-5245
Country	:	US
Telephone Number	:	803-773-8447
Fax Number	:	803-775-0751

Provider Business Practice Location Address
First Line	:	32 S MAIN ST
Second Line	:	SUITE A
City	:	SUMTER
State	:	SC
Zip	:	29150-5245
Country	:	US
Telephone Number	:	803-773-8447
Fax Number	:	803-775-0751

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JAMES B TALLON JR.
Credential	:
Telephone Number	:	803-773-8447

Provider Enumeration Date	:	04/12/2006
Last Update Date	:	05/30/2008

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Directions to “SUMTER MEDICAL SUPPLIES INC ” Practice Location

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