Provider Demographics
NPI:1205326360
Name:CAROLINA MEDICAL SUPPLY, LLC
Entity type:Organization
Organization Name:CAROLINA MEDICAL SUPPLY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:EDGAR
Authorized Official - Last Name:PENNELL
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:864-209-8245
Mailing Address - Street 1:212 E GREENVILLE ST
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29621-5509
Mailing Address - Country:US
Mailing Address - Phone:864-209-8245
Mailing Address - Fax:864-305-1015
Practice Address - Street 1:212 E GREENVILLE ST
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-5509
Practice Address - Country:US
Practice Address - Phone:864-209-8245
Practice Address - Fax:864-305-1015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-15
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies