360 DURABLE MEDICAL SUPPLIES & EQUIPMENT (NPI# 1457950875) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457950875 |
| Entity Type | Organization |
| Organization Name | 360 DURABLE MEDICAL SUPPLIES & EQUIPMENT |
| Practice Address |
1314 N Main St Ste D Fountain Inn SC 29644-1332 |
| Practice Telephone | 8646253252 |
| Mailing Telephone | 8646253252 |
| Enumeration Date | 2020-10-19 |
| Last Update Date | 2020-10-19 |
| Authorized Official Name | MICHAEL ANTHONY WALLACE (CEO) |
| Authorized Official Telephone | 8646253252 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers |
| Other Name | Type Code |
|---|---|
| 360 DURABLE MEDICAL SUPPLIES & EQUIPMENT | Doing Business As Name - Organization |
| Street Address |
1314 N MAIN ST STE D |
| City | FOUNTAIN INN |
| State | SC |
| Zip Code | 29644-1332 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669838991 | Palms Dentistry 225, LLC | Dentist | 208 Harrison Bridge Road, Fountain Inn, SC 29644 | 2015-12-31 |
| 1902155641 | Leah M Mauritz | Pharmacist | 203 N. Main St., Fountain Inn, SC 29644 | 2012-09-07 |
| 1164791778 | Lyfe Intervention Services | Community/Behavioral Health | 401 Putman Street, Fountain Inn, SC 29644 | 2011-12-28 |
| 1629119318 | South Carolina Department of Juvenile Justice | Residential Treatment Facility, Emotionally Disturbed Children | 810 Dunklin Bridge Road, Fountain Inn, SC 29644 | 2007-02-08 |
| 1093218992 | Emili Walker Hendrix | Occupational Therapist | 204 Shady Pines Ct, Fountain Inn, SC 29644 | 2018-03-16 |
| 1841331717 | South Carolina Department of Juvenile Justice | Residential Treatment Facility, Emotionally Disturbed Children | 810 Dunklin Bridge Road, Fountain Inn, SC 29644 | 2007-02-12 |
| 1912300971 | Grouphab | Clinic/Center | 30 Howard Creek Dr, Fountain Inn, SC 29644-1318 | 2014-10-06 |
| 1235653031 | Fountain Inn Dental, LLC | Dentist | 1125 N Main St, Fountain Inn, SC 29644-1322 | 2017-08-02 |
| 1790210839 | Mukta LLC | Pharmacy | 1103 N Main St Ste E, Fountain Inn, SC 29644-1336 | 2017-04-26 |
| 1457854564 | Tamera Burton Wilson | Specialist | 123 Village Vista Dr, Fountain Inn, SC 29644-1347 | 2018-03-15 |
| Find all providers in zip 29644 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881930659 | Panda Healthcare LLC | Durable Medical Equipment & Medical Supplies | 10 Jack Casey Ct, Suite E, Fountain Inn, SC 29644-9000 | 2012-12-21 |
| 1275734857 | Affordable Medical Home Supplies | Durable Medical Equipment & Medical Supplies | 420 Raspberry Ln, Fountain Inn, SC 29644-3512 | 2007-05-30 |
| 1346399987 | Constantly Caring Medical Services | Durable Medical Equipment & Medical Supplies | 218a S Main St, Fountain Inn, SC 29644-1912 | 2007-01-10 |
| 1083895304 | H.o.p.e Medical Supplies | Durable Medical Equipment & Medical Supplies | 420 Raspberry Ln, Fountain Inn, SC 29644-3512 | 2007-11-15 |
| 1871696542 | South Carolina Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 203 N Main St, Fountain Inn, SC 29644-1907 | 2006-09-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679174007 | Premier Transit Solutions, LLP | Durable Medical Equipment & Medical Supplies | 2025 Ebenezer Rd Ste J5, Rock Hill, SC 29732-1079 | 2020-11-03 |
| 1053912444 | Publix Super Markets, Inc | Durable Medical Equipment & Medical Supplies | 2501 May River Crossing, Bluffton, SC 29910 | 2020-11-03 |
| 1255938320 | Peninsula Cosmetic and Family Dentistry, Inc. | Durable Medical Equipment & Medical Supplies | 538 Savannah Hwy, Charleston, SC 29407-7210 | 2020-10-02 |
| 1700483971 | Rsfh - Ati Physical Therapy, LLC | Durable Medical Equipment & Medical Supplies | 8950 University Blvd Ste 200a, North Charleston, SC 29406-9115 | 2020-10-01 |
| 1356955983 | Greenville Health Corporation | Durable Medical Equipment & Medical Supplies | 1400 Pickens St Fl 3, Columbia, SC 29201-3465 | 2020-09-01 |
| 1437769494 | Publix Super Markets, Inc | Durable Medical Equipment & Medical Supplies | 1400 W Georgia Rd, Simpsonville, SC 29680-6305 | 2020-08-05 |
| 1154947208 | Southern Way Medical Supplies, LLC | Durable Medical Equipment & Medical Supplies | 145 Thomas Green Blvd Ste 100, Clemson, SC 29631-2172 | 2020-06-24 |
| 1841812252 | Yolanda Yvonne Ervin | Durable Medical Equipment & Medical Supplies | 1030 Oakland Ave Ste 104, Rock Hill, SC 29732-3074 | 2020-05-08 |
| 1750901674 | Harris Teeter LLC | Durable Medical Equipment & Medical Supplies | 100 Wade Hampton Blvd, Greenville, SC 29609-5735 | 2020-04-21 |
| 1801416870 | Tavon Johnson | Durable Medical Equipment & Medical Supplies | 5251 Hutton Ct, Florence, SC 29506-3466 | 2020-04-20 |
| Find all providers with the same taxonomy | ||||
| City | FOUNTAIN INN |
| Zip Code | 29644 |
Please comment or provide details below to improve the information on 360 DURABLE MEDICAL SUPPLIES & EQUIPMENT.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.