MEDICARE: STEDMAN HEALTH ASSOCIATES 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
2	3336C0003X	Community/Retail Pharmacy	04621	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	3423097	OTHER		NCPDP PROVIDER IDENTIFICATION NUMBER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023084985
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STEDMAN HEALTH ASSOCIATES INC

Provider Business Mailing Address
First Line	:	634 PINE RIDGE DR STE B
Second Line	:
City	:	WEST COLUMBIA
State	:	SC
Zip	:	29172-1885
Country	:	US
Telephone Number	:	803-240-9882
Fax Number	:	910-483-0515

Provider Business Practice Location Address
First Line	:	7445 CLINTON RD
Second Line	:
City	:	STEDMAN
State	:	NC
Zip	:	28391-8901
Country	:	US
Telephone Number	:	910-323-4555
Fax Number	:	910-483-0515

Authorized Official
Title or Position	:	PRESIDENT
Name	:	KYLE MCHUGH
Credential	:	RPH
Telephone Number	:	803-240-9882

Provider Enumeration Date	:	02/28/2006
Last Update Date	:	07/19/2021

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Directions to “STEDMAN HEALTH ASSOCIATES INC ” Practice Location

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