Healthcare Provider Details

I. General information

NPI: 1033441555
Provider Name (Legal Business Name): BILL HENRY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2010
Last Update Date: 02/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1252 OVERBROOK DR 15
GAFFNEY SC
29341-1057
US

IV. Provider business mailing address

108 ROYAL DR
GAFFNEY SC
29340-3669
US

V. Phone/Fax

Practice location:
  • Phone: 864-487-5584
  • Fax:
Mailing address:
  • Phone: 864-201-1404
  • Fax: 864-487-4570

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BN1400X
TaxonomyNursing Facility Supplies (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: MR. BILL HENRY
Title or Position: OWNER
Credential:
Phone: 864-201-1404