Provider Demographics
NPI:1912247842
Name:SPECIAL CARE MEDICAL OF SC INC
Entity Type:Organization
Organization Name:SPECIAL CARE MEDICAL OF SC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:WALTER
Authorized Official - Middle Name:D
Authorized Official - Last Name:MCLENDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-926-0161
Mailing Address - Street 1:PO BOX 21564
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29221-1564
Mailing Address - Country:US
Mailing Address - Phone:803-926-0161
Mailing Address - Fax:803-926-0345
Practice Address - Street 1:4421 ANNETTE ST STE 8
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409-2624
Practice Address - Country:US
Practice Address - Phone:803-926-0161
Practice Address - Fax:803-926-0345
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-01
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL51-8016088331-2332BX2000X
332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies