Healthcare Provider Details

I. General information

NPI: 1912278458
Provider Name (Legal Business Name): WHEELCHAIR AND SCOOTERS RENTALS OF MYRTLE BEACH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2012
Last Update Date: 01/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3012 MARSH ISLAND DR
MYRTLE BEACH SC
29579-5320
US

IV. Provider business mailing address

3012 MARSH ISLAND DR
MYRTLE BEACH SC
29579-5320
US

V. Phone/Fax

Practice location:
  • Phone: 843-457-7749
  • Fax:
Mailing address:
  • Phone: 843-457-7749
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number23251
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. MIK RUDY MUSILUNAS
Title or Position: OWNER
Credential:
Phone: 843-457-7749