MEDICARE: WINYAH 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	332BX2000X	Oxygen Equipment & Supplies (DME)	022150084	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	:	1366444374
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WINYAH HOME MEDICAL, INC

Provider Business Mailing Address
First Line	:	1101 CHURCH ST
Second Line	:
City	:	GEORGETOWN
State	:	SC
Zip	:	29440-3201
Country	:	US
Telephone Number	:	843-520-0300
Fax Number	:	843-520-0301

Provider Business Practice Location Address
First Line	:	1101 CHURCH ST
Second Line	:
City	:	GEORGETOWN
State	:	SC
Zip	:	29440-3201
Country	:	US
Telephone Number	:	843-520-0300
Fax Number	:	843-520-0301

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MRS. DANA L WHITLOCK
Credential	:
Telephone Number	:	843-520-0300

Provider Enumeration Date	:	08/10/2005
Last Update Date	:	05/09/2013

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Directions to “WINYAH HOME MEDICAL, INC ” Practice Location

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