Provider Demographics
NPI:1811239619
Name:SOUTHEAST MATERNAL MEDICAL SUPPLY INC
Entity Type:Organization
Organization Name:SOUTHEAST MATERNAL MEDICAL SUPPLY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JULEE
Authorized Official - Middle Name:
Authorized Official - Last Name:KRECHEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-458-0643
Mailing Address - Street 1:PO BOX 2036
Mailing Address - Street 2:
Mailing Address - City:PAWLEYS ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29585-2036
Mailing Address - Country:US
Mailing Address - Phone:843-310-4650
Mailing Address - Fax:
Practice Address - Street 1:14323 OCEAN HWY
Practice Address - Street 2:
Practice Address - City:PAWLEYS ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29585-4817
Practice Address - Country:US
Practice Address - Phone:832-310-4650
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-20
Last Update Date:2022-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies