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General NPI Number Information
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NPI Number | 1528034634
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Entity Type | Organization
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Legal Business Name | SHARON JORDAN
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Dates
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Enumeration Date | 02/28/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 570 BOILING SPRINGS RD
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City | LEXINGTON
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State | SC
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Zip | 29073-8307
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Country | US
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Telephone | 866-772-3557
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Fax | 803-894-5928
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Provider Business Mailing Address
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Address Line | PO BOX 84114
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City | LEXINGTON
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State | SC
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Zip | 29073-0002
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Country | US
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Telephone | 866-772-3557
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Fax | 803-894-5928
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Authorized Official
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Title or Position | SOLE PROPRIETOR
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Name | MS. SHARON JORDAN
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Credential |
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Telephone | 866-772-3557
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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 |
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License Number State |
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