Healthcare Provider Details
I. General information
NPI: 1407093974
Provider Name (Legal Business Name): PIGGLY WIGGLY FOLLY RD.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/20/2009
Last Update Date: 09/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1985 FOLLY RD
CHARLESTON SC
29412-9577
US
IV. Provider business mailing address
4401 PIGGLY WIGGLY DR. PO BOX 118047
CHARLESTON SC
29423
US
V. Phone/Fax
- Phone: 843-762-6591
- Fax: 843-762-9377
- Phone: 843-554-9980
- Fax: 843-202-8211
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
DAVID
SCHOOLS
Title or Position: PRESIDENT
Credential:
Phone: 843-554-9880