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NPI Code Detail

MEDICARE: EAU CLAIRE MEDICAL SUPPLY

MEDICARE: EAU CLAIRE MEDICAL SUPPLY
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
1332B00000XDurable Medical Equipment & Medical Supplies040010861SC
2251J00000XNursing Care Agency040010861SC

Other Identifiers

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

General Provider Information

NPI Number : 1265582449
Entity Type Code : Organization
Provider Name (Legal Business Name) : EAU CLAIRE MEDICAL SUPPLY
Provider Business Mailing Address
First Line : 4100 NORTH MAIN ST
Second Line : SUITE #100
City : COLUMBIA
State : SC
Zip : 29203-5800
Country : US
Telephone Number : 803-735-9849
Fax Number : 803-735-1710
Provider Business Practice Location Address
First Line : 4100 NORTH MAIN ST
Second Line : SUITE #100
City : COLUMBIA
State : SC
Zip : 29203-5800
Country : US
Telephone Number : 803-735-9849
Fax Number : 803-735-1710
Authorized Official
Title or Position : OWNER
Name : MR. MICHAEL L. FINKLIN
Credential : CPHT
Telephone Number : 803-735-9849
Provider Enumeration Date : 01/11/2007
Last Update Date : 07/30/2012

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Directions to “EAU CLAIRE MEDICAL SUPPLY ” Practice Location

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