Healthcare Provider Details

I. General information

NPI: 1023432390
Provider Name (Legal Business Name): CMA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2014
Last Update Date: 02/07/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1410 BLANDING ST SUITE 100
COLUMBIA SC
29201-2967
US

IV. Provider business mailing address

1410 BLANDING ST SUITE 100
COLUMBIA SC
29201-2967
US

V. Phone/Fax

Practice location:
  • Phone: 803-256-2728
  • Fax:
Mailing address:
  • Phone: 803-256-2728
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. DAVID LEE SMITH
Title or Position: OFFICE
Credential:
Phone: 803-467-7592