Provider Demographics
NPI:1821323437
Name:SUTTON'S MEDICAL (HOME SUPPLIES & EQUIPMENT)
Entity Type:Organization
Organization Name:SUTTON'S MEDICAL (HOME SUPPLIES & EQUIPMENT)
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:YOUNG
Authorized Official - Last Name:SUTTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-920-7776
Mailing Address - Street 1:PO BOX 2871
Mailing Address - Street 2:
Mailing Address - City:IRMO
Mailing Address - State:SC
Mailing Address - Zip Code:29063-4009
Mailing Address - Country:US
Mailing Address - Phone:803-920-7776
Mailing Address - Fax:803-407-2957
Practice Address - Street 1:15 BEECH BRANCH CT
Practice Address - Street 2:
Practice Address - City:IRMO
Practice Address - State:SC
Practice Address - Zip Code:29063-8046
Practice Address - Country:US
Practice Address - Phone:803-920-7776
Practice Address - Fax:803-407-2957
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-15
Last Update Date:2010-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2009-38960-38100332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies