Healthcare Provider Details

I. General information

NPI: 1912247842
Provider Name (Legal Business Name): SPECIAL CARE MEDICAL OF SC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2013
Last Update Date: 05/25/2022
Certification Date: 05/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4421 ANNETTE ST STE 8
WEST PALM BEACH FL
33409-2624
US

IV. Provider business mailing address

PO BOX 21564
COLUMBIA SC
29221-1564
US

V. Phone/Fax

Practice location:
  • Phone: 803-926-0161
  • Fax: 803-926-0345
Mailing address:
  • Phone: 803-926-0161
  • Fax: 803-926-0345

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number51-8016088331-2
License Number StateFL

VIII. Authorized Official

Name: MR. WALTER D MCLENDON
Title or Position: CEO/OWNER
Credential:
Phone: 803-926-0161