Provider Demographics
NPI:1144248113
Name:SILVA ENTERPRISES LLC
Entity type:Organization
Organization Name:SILVA ENTERPRISES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SERGIO
Authorized Official - Middle Name:
Authorized Official - Last Name:SILVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-532-2644
Mailing Address - Street 1:110 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LEESVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29070-8016
Mailing Address - Country:US
Mailing Address - Phone:803-532-2644
Mailing Address - Fax:803-532-2644
Practice Address - Street 1:110 MAIN ST
Practice Address - Street 2:
Practice Address - City:LEESVILLE
Practice Address - State:SC
Practice Address - Zip Code:29070-8016
Practice Address - Country:US
Practice Address - Phone:803-532-2644
Practice Address - Fax:803-532-2644
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-18
Last Update Date:2011-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC032352588332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCDE1997Medicaid
SC4635950001Medicare NSC