Provider Demographics
NPI:1225765043
Name:SHEPPARD MEDICAL LLC
Entity Type:Organization
Organization Name:SHEPPARD MEDICAL LLC
Other - Org Name:UNITED WOUND SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:BLAKE
Authorized Official - Last Name:SHEPPARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-696-2067
Mailing Address - Street 1:708 KENT ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-2606
Mailing Address - Country:US
Mailing Address - Phone:843-696-2067
Mailing Address - Fax:843-856-2906
Practice Address - Street 1:708 KENT ST
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-2606
Practice Address - Country:US
Practice Address - Phone:843-696-2067
Practice Address - Fax:843-696-2067
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-02
Last Update Date:2022-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies