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General NPI Number Information
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NPI Number | 1265582449
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Entity Type | Organization
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Legal Business Name | EAU CLAIRE MEDICAL SUPPLY
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Dates
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Enumeration Date | 01/11/2007
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Last Update Date | 07/30/2012
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Provider Practice Location Address
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Address Line | 4100 NORTH MAIN ST SUITE #100
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City | COLUMBIA
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State | SC
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Zip | 29203-5800
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Country | US
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Telephone | 803-735-9849
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Fax | 803-735-1710
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Provider Business Mailing Address
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Address Line | 4100 NORTH MAIN ST SUITE #100
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City | COLUMBIA
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State | SC
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Zip | 29203-5800
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Country | US
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Telephone | 803-735-9849
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Fax | 803-735-1710
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Authorized Official
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Title or Position | OWNER
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Name | MR. MICHAEL L. FINKLIN
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Credential | CPHT
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Telephone | 803-735-9849
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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 | 040010861
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | 040010861
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License Number State | SC
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