=====================================================
General NPI Number Information
=====================================================
NPI Number | 1770573263
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RELIABLE MEDICAL EQUIPMENT OF SOUTH CAROLINA, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/26/2005
-----------------------------------------------------
Last Update Date | 08/18/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2580 LIN DO CT STE B
-----------------------------------------------------
City | SUMTER
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29150-1832
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 803-934-9212
-----------------------------------------------------
Fax | 803-934-0750
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2580 LIN DO CT STE B
-----------------------------------------------------
City | SUMTER
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29150-1832
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 803-934-9212
-----------------------------------------------------
Fax | 803-934-0750
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MR. JEFFREY JOE REED
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 803-934-9212
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 335E00000X
-----------------------------------------------------
Taxonomy Name | Prosthetic/Orthotic Supplier
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | SC
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 332BX2000X
-----------------------------------------------------
Taxonomy Name | Oxygen Equipment & Supplies (DME)
-----------------------------------------------------
License Number | 65006651
-----------------------------------------------------
License Number State | SC
-----------------------------------------------------