Drusilla Fulton
Individual provider Active NPI Parenteral & Enteral Nutrition Supplies (DME) · Kingstree, SC
NPI 1104376573 · NPPES record last updated Oct 10, 2016
Key facts
- NPI
- 1104376573
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Parenteral & Enteral Nutrition Supplies (DME) 332BP3500X
- Practice address
- 44 Antioch Dr
Kingstree, SC 29556-5733 - Phone
- (704) 293-5718
- NPI assigned
- Oct 10, 2016
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bailey Transportation LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Parenteral & Enteral Nutrition Supplies (DME) | 332BP3500X | SC | Yes |
Addresses
Primary practice location
44 Antioch Dr
Kingstree, SC 29556-5733
Mailing address
44 Antioch Dr
Kingstree, SC 29556-5733
Phone (704) 293-5718
Other providers in Kingstree, SC
- Kyle Floyd
- Paul Fowler
- Frank a Trefny MD PA
- Stephanie Frommann
- Deborah E Fulton
- Lameka Fulton
- Melissa J Fulton
- Monique Fulton
- Shacovia Bone'T Fulton
- Tamika Landrina Fulton
All providers in Kingstree, SC · Parenteral & Enteral Nutrition Supplies (DME) in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 10, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.