Healthcare Provider Details

I. General information

NPI: 1275531659
Provider Name (Legal Business Name): RESOURCE MEDICAL GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2005
Last Update Date: 11/30/2022
Certification Date: 11/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 AZTEC CT
DUNCAN SC
29334-9457
US

IV. Provider business mailing address

110A AZTEC CT
DUNCAN SC
29334-9499
US

V. Phone/Fax

Practice location:
  • Phone: 864-233-6700
  • Fax: 864-233-6799
Mailing address:
  • Phone: 864-233-6700
  • Fax: 864-233-6799

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number2215574011
License Number StateSC

VIII. Authorized Official

Name: GREG CRAWFORD
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 859-441-8876