Provider Demographics
NPI:1134433501
Name:DORSI MEDICAL
Entity type:Organization
Organization Name:DORSI MEDICAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MBR
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:Y
Authorized Official - Last Name:BIGGERSTAFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-939-4673
Mailing Address - Street 1:1053 SUNSET BLVD.
Mailing Address - Street 2:
Mailing Address - City:WEST COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29169
Mailing Address - Country:US
Mailing Address - Phone:803-939-4673
Mailing Address - Fax:803-939-4674
Practice Address - Street 1:1053 SUNSET BLVD.
Practice Address - Street 2:
Practice Address - City:WEST COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29169
Practice Address - Country:US
Practice Address - Phone:803-939-4673
Practice Address - Fax:803-939-4674
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-28
Last Update Date:2010-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies