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General NPI Number Information
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NPI Number | 1982023115
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Entity Type | Organization
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Legal Business Name | NEW LIFE HEALTH AND MEDICAL
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Dates
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Enumeration Date | 04/15/2014
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Last Update Date | 04/15/2014
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Provider Practice Location Address
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Address Line | 701 MAIN ST. SUITE 150
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City | COLUMBIA
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State | SC
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Zip | 29201
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Country | US
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Telephone | 803-546-9553
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Fax |
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Provider Business Mailing Address
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Address Line | 701 GERVAIS ST SUITE 150
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City | COLUMBIA
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State | SC
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Zip | 29201-3066
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Country | US
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Telephone | 803-546-9553
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. CARLTON BOYD
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Credential | MHA, PHD
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Telephone | 803-546-9553
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State | SC
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Taxonomy #3
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Taxonomy Code | 3416A0800X
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Taxonomy Name | Air Ambulance
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number |
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License Number State | SC
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Taxonomy #5
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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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