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General NPI Number Information
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NPI Number | 1083927289
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Entity Type | Organization
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Legal Business Name | COLUMBIA MEDICAL SUPPLIES, LLC
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Dates
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Enumeration Date | 07/16/2010
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Last Update Date | 07/16/2010
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Provider Practice Location Address
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Address Line | 652 BUSH RIVER RD SUITE 202
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City | COLUMBIA
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State | SC
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Zip | 29210-7521
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Country | US
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Telephone | 803-772-9199
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Fax | 866-216-7997
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Provider Business Mailing Address
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Address Line | 652 BUSH RIVER RD SUITE 202
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City | COLUMBIA
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State | SC
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Zip | 29210-7521
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Country | US
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Telephone | 803-772-9199
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Fax | 866-216-7997
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. ARMEN MARTIROSYAN
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Credential |
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Telephone | 803-772-9199
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 09896
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License Number State | SC
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