Healthcare Provider Details

I. General information

NPI: 1558885483
Provider Name (Legal Business Name): ALLIED MEDICAL RESPIRATORY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/02/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 W 5TH NORTH STREET
SUMMERVILLE SC
29483
US

IV. Provider business mailing address

200 W 5TH NORTH ST
SUMMERVILLE SC
29483-6512
US

V. Phone/Fax

Practice location:
  • Phone: 843-285-7905
  • Fax: 843-285-7901
Mailing address:
  • Phone: 843-285-7905
  • Fax: 843-285-7901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: MR. TODD W BESON
Title or Position: CEO
Credential:
Phone: 843-285-7905