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General NPI Number Information
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NPI Number | 1174446884
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Entity Type | Organization
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Legal Business Name | MARA RAY LLC
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Dates
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Enumeration Date | 07/31/2026
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Last Update Date | 07/31/2026
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Provider Practice Location Address
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Address Line | 315 N BELTLINE DR STE C
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City | FLORENCE
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State | SC
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Zip | 29501-7420
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Country | US
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Telephone | 843-731-9186
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Fax | 843-351-6457
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Provider Business Mailing Address
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Address Line | 315 N BELTLINE DR STE C
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City | FLORENCE
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State | SC
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Zip | 29501-7420
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Country | US
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Telephone | 843-731-9186
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Fax | 843-351-6457
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Authorized Official
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Title or Position | OWNER/ MEMBER
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Name | MARA R CALDWELL
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Credential |
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Telephone | 843-731-9186
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224900000X
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Taxonomy Name | Mastectomy Fitter
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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