Provider Demographics
NPI:1508899964
Name:MEDICAL ESSENTIALS LLC
Entity Type:Organization
Organization Name:MEDICAL ESSENTIALS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:C
Authorized Official - Last Name:WELBAUM
Authorized Official - Suffix:
Authorized Official - Credentials:CFO,CPED
Authorized Official - Phone:864-234-1438
Mailing Address - Street 1:215 PELHAM RD STE B211
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-2548
Mailing Address - Country:US
Mailing Address - Phone:864-234-1438
Mailing Address - Fax:864-234-1408
Practice Address - Street 1:304 SOUTH MAIN STREET
Practice Address - Street 2:
Practice Address - City:SIMPSONVILLE
Practice Address - State:SC
Practice Address - Zip Code:29681-2606
Practice Address - Country:US
Practice Address - Phone:864-757-1467
Practice Address - Fax:864-757-1469
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-09
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCDE2650Medicaid
SC=========OtherUNITED HEALTHCARE
SC=========OtherAETNA
SC=========OtherHOME CARE NETWORK
SC=========OtherBLUE CROSS BLUE SHIELD
SC=========OtherBLUE CHOICE
SC=========OtherGOLD NET