Distinguished Crowns LLC

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

Legal business name

DISTINGUISHED CROWNS LLC

Practice address

4001 E Palmetto St Ste 1305
Florence, SC 29506-4213

Phone

(843) 624-0373

NPI assigned

Apr 5, 2021

Last updated

Sep 3, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Anzia Timmons WallaceNPI 1568037323

Title

Owner

Phone

(843) 624-0373

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Anzia Timmons Wallace, STUDENT COUNSELOR

  • Marriage & Family Therapist
  • Florence, SC
  • NPI 1568037323
  NPD Authorized official

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

{
    "created_epoch": "1617580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630627200000",
    "number": "1093394389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12176",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295042176",
            "telephone_number": "843-624-0373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4001 E PALMETTO ST STE 1305",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295064213",
            "telephone_number": "843-624-0373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DISTINGUISHED CROWNS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-05",
        "last_updated": "2021-09-03",
        "certification_date": "2021-09-03",
        "status": "A",
        "authorized_official_last_name": "TIMMONS WALLACE",
        "authorized_official_first_name": "ANZIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-624-0373"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Customized Equipment (DME) in Florence, SC
• Providers in Florence, SC by specialty
• Customized Equipment (DME) in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2021; 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.