Provider Demographics
NPI:1750482170
Name:CAROLINA SPORTS AND ORTHOPEDICS SALES INC
Entity Type:Organization
Organization Name:CAROLINA SPORTS AND ORTHOPEDICS SALES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:FREDERICK
Authorized Official - Middle Name:P
Authorized Official - Last Name:MURRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-763-5630
Mailing Address - Street 1:1223 REMOUNT RD
Mailing Address - Street 2:
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29406-3418
Mailing Address - Country:US
Mailing Address - Phone:800-775-5666
Mailing Address - Fax:843-763-8777
Practice Address - Street 1:1223 REMOUNT RD
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29406-3418
Practice Address - Country:US
Practice Address - Phone:800-775-5666
Practice Address - Fax:843-763-8777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2019-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC01075436-5332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC=========OtherBLUECROSS/BLUE SHIELD