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General NPI Number Information
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NPI Number | 1790073526
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Entity Type | Organization
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Legal Business Name | CONWAY MEDICAL SUPPLY
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Dates
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Enumeration Date | 07/14/2011
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Last Update Date | 07/14/2011
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Provider Practice Location Address
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Address Line | 117 WALNUT CT
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City | COLUMBIA
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State | SC
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Zip | 29212-8608
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Country | US
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Telephone | 803-543-8182
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Fax |
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Provider Business Mailing Address
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Address Line | 117 WALNUT CT
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City | COLUMBIA
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State | SC
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Zip | 29212-8608
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Country | US
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Telephone | 803-543-8182
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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. CHARLES CONWAY II
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Credential |
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Telephone | 803-543-8182
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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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