Provider Demographics
NPI:1528034634
Name:SHARON JORDAN
Entity Type:Organization
Organization Name:SHARON JORDAN
Other - Org Name:PRESSURE RELIEF SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:JORDAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:866-772-3557
Mailing Address - Street 1:PO BOX 84114
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29073-0002
Mailing Address - Country:US
Mailing Address - Phone:866-772-3557
Mailing Address - Fax:803-894-5928
Practice Address - Street 1:570 BOILING SPRINGS RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29073-8307
Practice Address - Country:US
Practice Address - Phone:866-772-3557
Practice Address - Fax:803-894-5928
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCDE2163Medicaid
SC4380890001Medicare NSC
SCDE2163Medicaid