MEDICARE: ABACARE HOME MEDICAL 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	010730667	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	:	1184735706
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABACARE HOME MEDICAL INC

Provider Business Mailing Address
First Line	:	2353 HWY 17 NORTH
Second Line	:
City	:	MOUNT PLEASANT
State	:	SC
Zip	:	29466-6807
Country	:	US
Telephone Number	:	843-375-2870
Fax Number	:	843-388-2550

Provider Business Practice Location Address
First Line	:	2353 HWY 17 NORTH
Second Line	:
City	:	MOUNT PLEASANT
State	:	SC
Zip	:	29466-6807
Country	:	US
Telephone Number	:	843-375-2870
Fax Number	:	843-388-2550

Authorized Official
Title or Position	:	CHIEF OPERATING OFFICER
Name	:	MR. PHILLIP DECLEMENTE
Credential	:
Telephone Number	:	843-375-2870

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	11/15/2007

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Directions to “ABACARE HOME MEDICAL INC ” Practice Location

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