Provider Demographics
NPI:1578269072
Name:CAROLINA SUPPLY AND LOGISTICS LLC
Entity Type:Organization
Organization Name:CAROLINA SUPPLY AND LOGISTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:COPPAGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-580-8173
Mailing Address - Street 1:8555 MARSH OVERLOOK
Mailing Address - Street 2:
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29420-9037
Mailing Address - Country:US
Mailing Address - Phone:843-580-8173
Mailing Address - Fax:
Practice Address - Street 1:8555 MARSH OVERLOOK
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29420-9037
Practice Address - Country:US
Practice Address - Phone:843-580-8173
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-06
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies