Healthcare Provider Details

I. General information

NPI: 1043535206
Provider Name (Legal Business Name): LYMIN INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2010
Last Update Date: 03/31/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9880 DORCHESTER RD
SUMMERVILLE SC
29485-8545
US

IV. Provider business mailing address

11900 US HIGHWAY 280
ELLABELL GA
31308-3603
US

V. Phone/Fax

Practice location:
  • Phone: 843-695-1611
  • Fax:
Mailing address:
  • Phone: 843-270-8929
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License NumberLIC-2-10-44334
License Number StateSC

VIII. Authorized Official

Name: ARTHUR SMITH
Title or Position: PRESIDENT
Credential: BC-HIS
Phone: 843-270-8929