Provider Demographics
NPI:1528038437
Name:LOW COUNTRY MEDICAL EQUIPMENT
Entity Type:Organization
Organization Name:LOW COUNTRY MEDICAL EQUIPMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:RODERICK
Authorized Official - Middle Name:D
Authorized Official - Last Name:URQUHART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-238-2388
Mailing Address - Street 1:PO BOX 1088
Mailing Address - Street 2:
Mailing Address - City:MURRELLS INLET
Mailing Address - State:SC
Mailing Address - Zip Code:29576-1088
Mailing Address - Country:US
Mailing Address - Phone:843-238-2388
Mailing Address - Fax:843-238-8655
Practice Address - Street 1:780 A HWY 17 S
Practice Address - Street 2:
Practice Address - City:SURFSIDE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29575
Practice Address - Country:US
Practice Address - Phone:843-238-2388
Practice Address - Fax:843-238-8655
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-24
Last Update Date:2011-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCDE2006Medicaid
SCDE2006Medicaid