Provider Demographics
NPI:1275734857
Name:AFFORDABLE MEDICAL HOME SUPPLIES
Entity Type:Organization
Organization Name:AFFORDABLE MEDICAL HOME SUPPLIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:RICHARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-408-9179
Mailing Address - Street 1:PO BOX 196
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN INN
Mailing Address - State:SC
Mailing Address - Zip Code:29644-0196
Mailing Address - Country:US
Mailing Address - Phone:864-408-9179
Mailing Address - Fax:866-285-4874
Practice Address - Street 1:420 RASPBERRY LN
Practice Address - Street 2:
Practice Address - City:FOUNTAIN INN
Practice Address - State:SC
Practice Address - Zip Code:29644-3512
Practice Address - Country:US
Practice Address - Phone:864-408-9179
Practice Address - Fax:866-285-4874
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-30
Last Update Date:2007-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies