MEDSOURCE MEDICAL DME LLC (NPI# 1508030743) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508030743 |
| Entity Type | Organization |
| Organization Name | MEDSOURCE MEDICAL DME LLC |
| Other Organization Name | MEDSOURCE MEDICAL DME LLC |
| Practice Address |
320 Midland Pkwy Ste B Summerville SC 29485-7197 |
| Practice Telephone | 8439065020 |
| Practice Fax Number | 8439708055 |
| Mailing Telephone | 8439065020 |
| Mailing Fax Number | 8437713200 |
| Enumeration Date | 2008-04-18 |
| Last Update Date | 2017-03-20 |
| Authorized Official Name | MRS. MELINDA CAMPBELL DINGLE (OWNER) |
| Authorized Official Telephone | 8439065020 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | SC | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | DE2428 | 05 |
| Other Name | Type Code |
|---|---|
| Medsource Medical DME LLC | Doing Business As Name - Organization |
| Street Address |
320 MIDLAND PKWY STE B |
| City | SUMMERVILLE |
| State | SC |
| Zip Code | 29485-7197 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780282855 | Rebekah Phillips Tozer | Counselor | 320 Midland Pkwy, Summerville, SC 29485-7197 | 2020-10-12 |
| 1649636473 | Young Joo Kim | Dentist | 320 Midland Pkwy, Suite A, Summerville, SC 29485-7197 | 2016-01-09 |
| 1790159465 | Delite Dental | Clinic/Center | 320 Midland Pkwy, Ste A, Summerville, SC 29485-7197 | 2015-11-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487267365 | Cp Dentistry, LLC | Dentist | 9919 Dorchester Road, Summerville, SC 29485 | 2020-08-28 |
| 1922622604 | Rachel Elaine Digiacomo | Physical Therapist | 10160 Dorchester Road, Summerville, SC 29485 | 2020-05-29 |
| 1396220034 | Amanda W Peebles | Nurse Practitioner | 4278 Ladson Rd., Summerville, SC 29485 | 2018-09-28 |
| 1396230728 | Gerald Darnell Woods | Counselor | 10825 Dorchester Rd. #3077, Summerville, SC 29485 | 2018-06-27 |
| 1063901072 | Elite Barber Spa, LLC | Specialist | 850 E Bacons Bridge Road, Suite 303, Summerville, SC 29485 | 2018-05-04 |
| 1598253528 | Daniel Joseph Neitzke | Student in an Organized Health Care Education/Training Program | 9228 Medical Plaza Drive, Charleston, SC 29485 | 2018-04-25 |
| 1700315447 | Donna Marie White | Counselor | 9214 Ayscough Road, Summerville, SC 29485 | 2017-06-07 |
| 1043763212 | Brockman Davis Smith | Dentist | 1710 B Trolley Road, Summerville, SC 29485 | 2016-07-25 |
| 1336508530 | Meca Home Health, LLC | Home Health | 415 Savannah River Rd, Summerville, SC 29485 | 2016-02-16 |
| 1609241033 | Dental Professionals of South Carolina, PC | Dentist | 9510 Dorchester Rd, Suite 400, North Charleston, SC 29485 | 2015-12-10 |
| Find all providers in zip 29485 | ||||
| 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 |
|---|---|---|---|---|
| 1881240836 | Donaco Medical Supply LLC | Durable Medical Equipment & Medical Supplies | 89 Old Trolley Rd Ste 211, Summerville, SC 29485-4951 | 2019-08-15 |
| 1013472398 | Two Rivers Medical | Durable Medical Equipment & Medical Supplies | 2219 Sandtuck Cir, Summerville, SC 29483-5544 | 2019-01-31 |
| 1861889610 | Rock Creek Ortho Gear | Durable Medical Equipment & Medical Supplies | 1317 N Main St Ste M, Mb302, Summerville, SC 29483-7380 | 2015-04-20 |
| 1447421979 | Bulldog Commercial Construction, LLC | Durable Medical Equipment & Medical Supplies | 103 Foxcroft Ln, Summerville, SC 29485-8623 | 2008-03-12 |
| 1487849949 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 1584 Central Ave, Summerville, SC 29483-5528 | 2007-09-07 |
| 1265641237 | T & T Technology Inc | Durable Medical Equipment & Medical Supplies | 108 Edgebrook Dr, Summerville, SC 29483-8780 | 2007-05-22 |
| 1346454709 | Rehabilitation Centers of Charleston | Durable Medical Equipment & Medical Supplies | 330 E 5th North St, Suite D, Summerville, SC 29483 | 2007-05-09 |
| 1720111305 | South Carolina Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 1602 Central Ave, Summerville, SC 29483-5528 | 2007-03-13 |
| 1679609754 | Coastal Carolina Medical Services LLC | Durable Medical Equipment & Medical Supplies | 106 Pine Ct, Summerville, SC 29483-8283 | 2007-02-26 |
| 1861580987 | Medicine Man Medical Supplies and Equipment | Durable Medical Equipment & Medical Supplies | 404 Old Trolley Rd, Summerville, SC 29485-5661 | 2006-10-11 |
| Find all providers in SUMMERVILLE | ||||
| City | SUMMERVILLE |
| Zip Code | 29485 |
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| 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.