Provider Demographics
NPI:1043720964
Name:CHARTWELL DURABLE MEDICAL SUPPLY, LLC
Entity Type:Organization
Organization Name:CHARTWELL DURABLE MEDICAL SUPPLY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAY
Authorized Official - Middle Name:
Authorized Official - Last Name:MARQUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:843-804-8100
Mailing Address - Street 1:671 JAMESTOWN DRIVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:MURRELLS INLET
Mailing Address - State:SC
Mailing Address - Zip Code:29576
Mailing Address - Country:US
Mailing Address - Phone:843-649-0080
Mailing Address - Fax:843-947-0066
Practice Address - Street 1:671 JAMESTOWN DRIVE
Practice Address - Street 2:SUITE 104
Practice Address - City:MURRELLS INLET
Practice Address - State:SC
Practice Address - Zip Code:29576
Practice Address - Country:US
Practice Address - Phone:843-649-0080
Practice Address - Fax:843-947-0066
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-05
Last Update Date:2019-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies