Healthcare Provider Details

I. General information

NPI: 1659137032
Provider Name (Legal Business Name): SMITHCO SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2024
Last Update Date: 02/23/2024
Certification Date: 02/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1640 BERTHA MARIE LN
WADMALAW ISLAND SC
29487-7188
US

IV. Provider business mailing address

1640 BERTHA MARIE LN
WADMALAW ISLAND SC
29487-7188
US

V. Phone/Fax

Practice location:
  • Phone: 843-475-3511
  • Fax:
Mailing address:
  • Phone: 843-475-3511
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171WH0202X
TaxonomyHome Modifications Contractor
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL D SMITH
Title or Position: OWNER
Credential:
Phone: 843-475-3511