Healthcare Provider Details

I. General information

NPI: 1194066704
Provider Name (Legal Business Name): LOW COUNTRY HOME MEDICAL EQUIPMENT COMPANY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2013
Last Update Date: 03/06/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1104 N JEFFERIES BLVD
WALTERBORO SC
29488-2730
US

IV. Provider business mailing address

1104 N JEFFERIES BLVD
WALTERBORO SC
29488-2730
US

V. Phone/Fax

Practice location:
  • Phone: 843-782-4307
  • Fax: 843-782-4309
Mailing address:
  • Phone: 843-782-4307
  • Fax: 843-782-4309

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 StateSC

VIII. Authorized Official

Name: MARK BATY
Title or Position: VP/OPERATIONS
Credential:
Phone: 843-209-7185