MEDICARE: EAGLE POINT SUPPLIES, LLC

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

General Provider Information

NPI Number	:	1396120465
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EAGLE POINT SUPPLIES, LLC

Provider Business Mailing Address
First Line	:	8983 UNIVERSITY BLVD
Second Line	:	STE 104 - 103
City	:	NORTH CHARLESTON
State	:	SC
Zip	:	29406-7102
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8983 UNIVERSITY BLVD
Second Line	:	STE 104 - 103
City	:	NORTH CHARLESTON
State	:	SC
Zip	:	29406-7102
Country	:	US
Telephone Number	:	803-305-9120
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	THOM THOMAS
Credential	:
Telephone Number	:	803-305-9120

Provider Enumeration Date	:	07/29/2015
Last Update Date	:	07/29/2015

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Directions to “EAGLE POINT SUPPLIES, LLC ” Practice Location

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