Organization Name: | CARDIOSOM, LLC |
NPI Number: | 1033176011 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JAY JARRELL (PRESIDENT/COO) |
Mailing Address: | 1330 Boiling Springs Rd Suite 2900 Spartanburg |
State: | SC US |
Postal Code: | 293034201 |
Phone Number: | 8645293460 |
Fax Number: | 8645293461 |
NPI Enumeration Date: | 04/26/2006 |
NPI Last Update Date: | 08/10/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332BX2000X |
License Number: | 042508857 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SC |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | Oxygen Equipment & Supplies |
Taxonomy Definition: |