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General NPI Number Information
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NPI Number | 1376633016
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Entity Type | Organization
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Legal Business Name | CONVACARE, INC.
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Dates
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Enumeration Date | 10/13/2006
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Last Update Date | 06/09/2009
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Provider Practice Location Address
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Address Line | 249C COLUMBIA ST
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City | CHESTER
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State | SC
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Zip | 29706-2017
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Country | US
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Telephone | 803-581-2313
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2235
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City | IRMO
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State | SC
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Zip | 29063-7235
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Country | US
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Telephone | 803-581-2313
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. EDWARD P. HAMMOND
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Credential |
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Telephone | 803-581-2313
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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 | 01207563
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License Number State | SC
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