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General NPI Number Information
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NPI Number | 1336281161
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Entity Type | Organization
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Legal Business Name | COLE-MCGILL ENTERPRISES
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Dates
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Enumeration Date | 02/12/2007
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Last Update Date | 08/22/2008
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Provider Practice Location Address
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Address Line | 115 W MAIN ST
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City | LIBERTY
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State | SC
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Zip | 29657-1140
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Country | US
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Telephone | 864-843-9207
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Fax | 864-843-9208
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Provider Business Mailing Address
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Address Line | PO BOX 63
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City | LIBERTY
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State | SC
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Zip | 29657-0063
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Country | US
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Telephone | 864-843-9207
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Fax | 864-843-9208
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Authorized Official
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Title or Position | SECRETARY-TREASURER
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Name | MR. WALTER A. TOOLE
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Credential | R.PH.
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Telephone | 864-843-9207
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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 | 613090
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License Number State | SC
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