MEDICARE: RJS SAS SHOES 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	332BC3200X	Customized Equipment (DME)	332BC3200X	SC

General Provider Information

NPI Number	:	1891987897
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RJS SAS SHOES INC

Provider Business Mailing Address
First Line	:	3306 FOREST DR
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29204-4024
Country	:	US
Telephone Number	:	803-782-3668
Fax Number	:	803-787-7258

Provider Business Practice Location Address
First Line	:	3306 FOREST DR
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29204-4024
Country	:	US
Telephone Number	:	803-782-3668
Fax Number	:	803-787-7258

Authorized Official
Title or Position	:	MANAGER
Name	:	BLAIN PRITCHER
Credential	:
Telephone Number	:	803-782-3662

Provider Enumeration Date	:	08/14/2007
Last Update Date	:	08/14/2007

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Directions to “RJS SAS SHOES INC ” Practice Location

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