Provider Demographics
NPI:1881035418
Name:SYNERGY MEDICAL, LLC
Entity Type:Organization
Organization Name:SYNERGY MEDICAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:W
Authorized Official - Last Name:ROBBINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-457-2222
Mailing Address - Street 1:110 N RANDOLPH AVE
Mailing Address - Street 2:
Mailing Address - City:LANDRUM
Mailing Address - State:SC
Mailing Address - Zip Code:29356-1512
Mailing Address - Country:US
Mailing Address - Phone:864-457-2222
Mailing Address - Fax:864-457-2269
Practice Address - Street 1:831 1ST ST N
Practice Address - Street 2:
Practice Address - City:ALABASTER
Practice Address - State:AL
Practice Address - Zip Code:35007-8944
Practice Address - Country:US
Practice Address - Phone:205-358-9120
Practice Address - Fax:864-457-2269
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SYNERGY MEDICAL, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-07-11
Last Update Date:2013-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC13549332B00000X
335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCDE3416Medicaid
SC1093952731OtherBCBS OF SC
NC7705390Medicaid
NC7705390Medicaid