Healthcare Provider Details

I. General information

NPI: 1467934463
Provider Name (Legal Business Name): MARTIN SUPPLY & DISTRIBUTION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/05/2018
Last Update Date: 05/30/2023
Certification Date: 05/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1306 W POINSETT ST
GREER SC
29650-1250
US

IV. Provider business mailing address

1306 W POINSETT ST
GREER SC
29650-1250
US

V. Phone/Fax

Practice location:
  • Phone: 347-668-8879
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateSC

VIII. Authorized Official

Name: YAHNICK MARTIN
Title or Position: CEO/FOUNDER
Credential:
Phone: 347-278-9784