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General NPI Number Information
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NPI Number | 1568692994
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Entity Type | Organization
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Legal Business Name | PIGGLY WIGGLY NO.41, INC.
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Dates
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Enumeration Date | 07/20/2009
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Last Update Date | 04/12/2010
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Provider Practice Location Address
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Address Line | 9616 HIGHWAY 78
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City | LADSON
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State | SC
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Zip | 29456-3501
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Country | US
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Telephone | 843-797-8510
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Fax | 843-797-0128
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Provider Business Mailing Address
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Address Line | PO BOX 118047
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City | CHARLESTON
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State | SC
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Zip | 29423-8047
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Country | US
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Telephone | 843-554-9880
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Fax | 843-202-8211
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. DAVID R. SCHOOLS
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Credential |
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Telephone | 843-554-9880
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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 | 5007349
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License Number State | SC
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