Healthcare Provider Details

I. General information

NPI: 1164745279
Provider Name (Legal Business Name): LYMIN INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

2921 AUGUSTA RD STE B
WEST COLUMBIA SC
29170-3324
US

IV. Provider business mailing address

2921 AUGUSTA RD STE B
WEST COLUMBIA SC
29170-3324
US

V. Phone/Fax

Practice location:
  • Phone: 803-939-0003
  • Fax:
Mailing address:
  • Phone: 803-939-0003
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number073468
License Number StateSC

VIII. Authorized Official

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