Provider Demographics
NPI:1578064192
Name:ANCILLARY SPECIALISTS LLC
Entity Type:Organization
Organization Name:ANCILLARY SPECIALISTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:PINKSTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-814-1367
Mailing Address - Street 1:295 SEVEN FARMS DR UNIT C117
Mailing Address - Street 2:
Mailing Address - City:DANIEL ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29492-8001
Mailing Address - Country:US
Mailing Address - Phone:843-814-1367
Mailing Address - Fax:800-788-4087
Practice Address - Street 1:295 SEVEN FARMS DR UNIT C117
Practice Address - Street 2:
Practice Address - City:DANIEL ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29492-8001
Practice Address - Country:US
Practice Address - Phone:843-814-1367
Practice Address - Fax:800-788-4087
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-28
Last Update Date:2022-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies