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General NPI Number Information
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NPI Number | 1851597488
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Entity Type | Organization
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Legal Business Name | PERFORMANCE MEDICAL SUPPLY INC.
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Dates
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Enumeration Date | 06/21/2007
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Last Update Date | 05/07/2008
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Provider Practice Location Address
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Address Line | 622 OLD TROLLEY RD SUITE 126
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City | SUMMERVILLE
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State | SC
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Zip | 29485-5674
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Country | US
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Telephone | 843-486-5274
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Fax | 843-486-5279
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Provider Business Mailing Address
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Address Line | 622 OLD TROLLEY RD SUITE 126
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City | SUMMERVILLE
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State | SC
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Zip | 29485-5674
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Country | US
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Telephone | 843-486-5274
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Fax | 843-486-5279
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Authorized Official
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Title or Position | OWNER
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Name | MR. KEVIN M HESTER
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Credential |
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Telephone | 803-791-5904
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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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