Healthcare Provider Details

I. General information

NPI: 1750322558
Provider Name (Legal Business Name): LTC HEALTH SOLUTIONS MEDICAL EQUIPMENT, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2006
Last Update Date: 05/18/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3685 LEAPHART ROAD SUITE A
WEST COLUMBIA SC
29169
US

IV. Provider business mailing address

3685 LEAPHART ROAD SUITE A
WEST COLUMBIA SC
29169
US

V. Phone/Fax

Practice location:
  • Phone: 803-939-0757
  • Fax: 803-939-0757
Mailing address:
  • Phone: 803-939-0757
  • Fax: 803-939-0964

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BN1400X
TaxonomyNursing Facility Supplies (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateSC

VIII. Authorized Official

Name: MR. DANIEL R HUTTO JR.
Title or Position: PRESIDENT
Credential:
Phone: 803-939-0757