Healthcare Provider Details

I. General information

NPI: 1568692994
Provider Name (Legal Business Name): PIGGLY WIGGLY NO.41, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2009
Last Update Date: 04/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9616 HIGHWAY 78
LADSON SC
29456-3501
US

IV. Provider business mailing address

PO BOX 118047
CHARLESTON SC
29423-8047
US

V. Phone/Fax

Practice location:
  • Phone: 843-797-8510
  • Fax: 843-797-0128
Mailing address:
  • Phone: 843-554-9880
  • Fax: 843-202-8211

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number5007349
License Number StateSC

VIII. Authorized Official

Name: MR. DAVID R. SCHOOLS
Title or Position: PRESIDENT
Credential:
Phone: 843-554-9880