MEDICARE: PIGGLY WIGGLY ANDREWS, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies	5001882	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003004995
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PIGGLY WIGGLY ANDREWS, INC.

Provider Business Mailing Address
First Line	:	PO BOX 118047
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29423-8047
Country	:	US
Telephone Number	:	843-554-9880
Fax Number	:	843-202-8211

Provider Business Practice Location Address
First Line	:	15 WEST ASHLAND AVE.
Second Line	:
City	:	ANDREWS
State	:	SC
Zip	:	29510-2543
Country	:	US
Telephone Number	:	843-264-3291
Fax Number	:	843-264-5425

Authorized Official
Title or Position	:	CEO/PRESIDENT
Name	:	MR. DAVID R. SCHOOL
Credential	:
Telephone Number	:	843-554-9880

Provider Enumeration Date	:	10/05/2007
Last Update Date	:	08/01/2011

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