Healthcare Provider Details

I. General information

NPI: 1558932426
Provider Name (Legal Business Name): ADVANTAGE HEALTHCARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2021
Last Update Date: 04/03/2024
Certification Date: 04/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

746 HILLCREST LN
MC BEE SC
29101-8896
US

IV. Provider business mailing address

746 HILLCREST LN
MC BEE SC
29101-8896
US

V. Phone/Fax

Practice location:
  • Phone: 843-622-8381
  • Fax:
Mailing address:
  • Phone: 843-622-8381
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code293D00000X
TaxonomyPhysiological Laboratory
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: DARREL WALTERS
Title or Position: OWNER
Credential:
Phone: 910-733-0839