Organization Name: | CLEMSON SPORTS MEDICINE AND REHABILITATION |
NPI Number: | 1386886588 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DEBBIE BAXTER (CREDENTIALING SPECIALIST) |
Mailing Address: | 4237 River Hills Dr Suite 120 Little River |
State: | SC US |
Postal Code: | 295666444 |
Phone Number: | 8432495616 |
Fax Number: | 8432491843 |
NPI Enumeration Date: | 04/02/2009 |
NPI Last Update Date: | 01/13/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | |
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 |