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General NPI Number Information
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NPI Number | 1699094664
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Entity Type | Organization
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Legal Business Name | ESSEX MEDICAL SUPPLY
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Dates
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Enumeration Date | 05/28/2010
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Last Update Date | 05/28/2010
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Provider Practice Location Address
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Address Line | 20 TOWNE DR SUITE 246
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City | BLUFFTON
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State | SC
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Zip | 29910-4204
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Country | US
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Telephone | 843-837-3758
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Fax | 866-936-8405
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Provider Business Mailing Address
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Address Line | 20 TOWNE DR SUITE 246
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City | BLUFFTON
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State | SC
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Zip | 29910-4204
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Country | US
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Telephone | 843-837-3758
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Fax | 866-936-8405
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. ANDREW H. KEIL
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Credential |
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Telephone | 843-837-3758
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number | AK2734
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License Number State | SC
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Taxonomy #2
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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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