Healthcare Provider Details

I. General information

NPI: 1699967091
Provider Name (Legal Business Name): ADVANTAGE HOME MEDICAL COMPANY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2007
Last Update Date: 08/10/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3093 S HIGHWAY 14 SUITE A
GREER SC
29650-4829
US

IV. Provider business mailing address

3093 SOUTH HIGHWAY 14 SUITE A
GREER SC
29650-4830
US

V. Phone/Fax

Practice location:
  • Phone: 864-297-6749
  • Fax: 864-297-6791
Mailing address:
  • Phone: 864-297-6749
  • Fax: 864-297-6791

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number65008374
License Number StateSC

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MR. BILL BISHOP
Title or Position: OWNER/PRESIDENT
Credential:
Phone: 864-627-9669