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General NPI Number Information
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NPI Number | 1275978389
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Entity Type | Organization
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Legal Business Name | ABC MEDICAL OF CHARLESTON LLC
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Dates
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Enumeration Date | 05/02/2013
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Last Update Date | 05/02/2013
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Provider Practice Location Address
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Address Line | 105 HUGHES ST
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City | SUMMERVILLE
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State | SC
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Zip | 29483-4228
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Country | US
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Telephone | 843-532-3740
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Fax |
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Provider Business Mailing Address
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Address Line | 105 HUGHES ST
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City | SUMMERVILLE
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State | SC
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Zip | 29483-4228
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Country | US
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Telephone | 843-532-3740
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LEONARD GREEN
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Credential |
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Telephone | 843-532-3740
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number |
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License Number State |
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