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General NPI Number Information
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NPI Number | 1912627845
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Entity Type | Individual
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Provider Name | ANDREA PINKSTON
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Gender | Female
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Dates
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Enumeration Date | 08/31/2022
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Last Update Date | 02/12/2025
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Provider Practice Location Address
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Address Line | 1671 BELLE ISLE AVE STE 110 OFFICE M
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City | MOUNT PLEASANT
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State | SC
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Zip | 29464-8336
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Country | US
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Telephone | 854-444-7124
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Fax | 800-788-4087
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Provider Business Mailing Address
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Address Line | 295 SEVEN FARMS DR STE C-117
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City | DANIEL ISLAND
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State | SC
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Zip | 29492-8001
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Country | US
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Telephone | 843-810-3741
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | DE4090
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number | 2822483
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License Number State | SC
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Taxonomy #3
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 2822483
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License Number State | SC
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