Organization Name: | CHARLESTON BRACE COMPANY, LLC |
NPI Number: | 1265813968 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | NATHANIEL A JACKSON (CO) |
Mailing Address: | 1220-b Hospital Drive Mt Pleasant |
State: | SC US |
Postal Code: | 294643678 |
Phone Number: | 8438491930 |
Fax Number: | 8438491932 |
NPI Enumeration Date: | 06/18/2015 |
NPI Last Update Date: | 03/21/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | 010116126 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SC |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | |
Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |