Peacock Medical Equipment & Home Health Care LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

PEACOCK MEDICAL EQUIPMENT & HOME HEALTH CARE LLC

Practice address

1499 John C Calhoun Dr
Orangeburg, SC 29115-7280

Phone

(803) 937-5532

Fax

(800) 419-1565

NPI assigned

Mar 24, 2010

Organization subpart

Yes

Parent organization

PEACOCK MEDICAL EQUIPMENT & HOME HEALTH CARE LLCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Adam D Wellington, PH.D

Title

President/Member

Phone

(423) 547-3224

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Peacock Medical Equipment and Home Health Care LLC2 organizations share this tax ID, including this one

Part of

Peacock Medical Equipment and Home Health Care LLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Peaock Medical Equipment & Home Health Care LLC

  • Durable Medical Equipment & Medical Supplies
  • Spartanburg, SC
  • NPI 1912221664
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1269388800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1269388800000",
    "number": "1043534787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 HIGHWAY 37 19E STE 3",
            "city": "ELIZABETHTON",
            "state": "TN",
            "postal_code": "376434678",
            "telephone_number": "423-547-3224",
            "fax_number": "800-419-1565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1499 JOHN C CALHOUN DR",
            "city": "ORANGEBURG",
            "state": "SC",
            "postal_code": "291157280",
            "telephone_number": "803-937-5532",
            "fax_number": "800-419-1565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACOCK MEDICAL EQUIPMENT & HOME HEALTH CARE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PEACOCK MEDICAL EQUIPMENT & HOME HEALTH CARE LLC",
        "enumeration_date": "2010-03-24",
        "last_updated": "2010-03-24",
        "status": "A",
        "authorized_official_last_name": "WELLINGTON",
        "authorized_official_first_name": "ADAM",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT/MEMBER",
        "authorized_official_telephone_number": "423-547-3224",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DM1334",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mehul Patel, DPT
• Rubin Gopal Patel, MD
• Ellen Fay Patrick, PT
• Mary Braxton Patrick, PA
• Christy Kandi Patterson
• Ben C Pendarvis Jr., M.D.
• Vincent Pendarvis, M.ED
• Boris Penev, DO
• Sara Rose Peters, PA-C
• Matthew Seth Petitt, MD

• Durable Medical Equipment & Medical Supplies in Orangeburg, SC
• Providers in Orangeburg, SC by specialty
• Durable Medical Equipment & Medical Supplies in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.