Provider Demographics
NPI:1932434768
Name:TARTE, PAULA HICKS
Entity Type:Individual
Prefix:MRS
First Name:PAULA
Middle Name:HICKS
Last Name:TARTE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3679 HIGHWAY 57 S
Mailing Address - Street 2:
Mailing Address - City:FORK
Mailing Address - State:SC
Mailing Address - Zip Code:29543-6197
Mailing Address - Country:US
Mailing Address - Phone:843-409-5524
Mailing Address - Fax:
Practice Address - Street 1:3679 HIGHWAY 57 S
Practice Address - Street 2:
Practice Address - City:FORK
Practice Address - State:SC
Practice Address - Zip Code:29543-6197
Practice Address - Country:US
Practice Address - Phone:843-409-5524
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-13
Last Update Date:2009-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332BD1200XSuppliersDurable Medical Equipment & Medical SuppliesDialysis Equipment & Supplies
No332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies