Healthcare Provider Details

I. General information

NPI: 1083680938
Provider Name (Legal Business Name): HOME MEDICAL SUPPLIES & EQUIPMENT, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2006
Last Update Date: 08/30/2023
Certification Date: 08/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

415 ALTMAN ST
MONCKS CORNER SC
29461-3656
US

IV. Provider business mailing address

415 ALTMAN ST
MONCKS CORNER SC
29461-3656
US

V. Phone/Fax

Practice location:
  • Phone: 843-761-3248
  • Fax: 843-761-3237
Mailing address:
  • Phone: 843-761-3248
  • Fax: 843-761-2764

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number008147819S
License Number StateSC

VIII. Authorized Official

Name: LISA B YOUNG
Title or Position: CEO
Credential:
Phone: 843-729-5851