Provider Demographics
NPI:1205044500
Name:CAROLINA MOBILITY OF HARTSVILLE LLC
Entity Type:Organization
Organization Name:CAROLINA MOBILITY OF HARTSVILLE LLC
Other - Org Name:CAROLINA MOBILITY OF HARTSVILLE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:THOMY
Authorized Official - Last Name:WINDHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-665-5678
Mailing Address - Street 1:PO BOX 808
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29503-0808
Mailing Address - Country:US
Mailing Address - Phone:843-332-2221
Mailing Address - Fax:843-669-8842
Practice Address - Street 1:1830 S 5TH ST
Practice Address - Street 2:
Practice Address - City:HARTSVILLE
Practice Address - State:SC
Practice Address - Zip Code:29550-5759
Practice Address - Country:US
Practice Address - Phone:843-332-2221
Practice Address - Fax:843-669-8842
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies