Provider Demographics
NPI:1619190014
Name:HEYWARD WATSON MEDICAL INC
Entity Type:Organization
Organization Name:HEYWARD WATSON MEDICAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNERPARTNER
Authorized Official - Prefix:MS
Authorized Official - First Name:REGINA
Authorized Official - Middle Name:
Authorized Official - Last Name:HEYWARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-788-1236
Mailing Address - Street 1:PO BOX 291584
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29229-0027
Mailing Address - Country:US
Mailing Address - Phone:803-317-4911
Mailing Address - Fax:888-243-3895
Practice Address - Street 1:9610 TWO NOTCH RD
Practice Address - Street 2:3
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29223-1601
Practice Address - Country:US
Practice Address - Phone:803-788-1236
Practice Address - Fax:888-243-3895
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies