Provider Demographics
NPI:1083640940
Name:ANMED HEALTH
Entity Type:Organization
Organization Name:ANMED HEALTH
Other - Org Name:IMPRESSIONS APPEARANCE SHOPPE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:PEARSON
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:864-512-1104
Mailing Address - Street 1:PO BOX 195
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29622-0195
Mailing Address - Country:US
Mailing Address - Phone:864-512-4761
Mailing Address - Fax:864-512-4763
Practice Address - Street 1:2000 E GREENVILLE ST
Practice Address - Street 2:SUITE 5010
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-1580
Practice Address - Country:US
Practice Address - Phone:864-512-4761
Practice Address - Fax:864-512-4763
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-23
Last Update Date:2019-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC332B00000X
335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCDE2781Medicaid
SCDE2781Medicaid
SC=========048OtherBLUE CROSS OF SC