Airway Medical Supplies, Inc.
Organization Active NPI Durable Medical Equipment & Medical Supplies · Gaffney, SC
NPI 1164587747 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1164587747
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Durable Medical Equipment & Medical Supplies 332B00000X
- Legal business name
- AIRWAY MEDICAL SUPPLIES, INC.
- Practice address
- 1115 N Logan St
Gaffney, SC 29341-2022 - Phone
- (864) 487-2142
- Fax
- (864) 487-2162
- NPI assigned
- Dec 26, 2006
- Organization subpart
- No
Authorized official
- Name
- Melanie Roberts Baker
- Title
- Owner
- Phone
- (864) 487-2142
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930016273 | SC | DME Supplier - Medical Supply Company With Respiratory Therapist |
3274745807 | Practice locations: Gaffney, SC |
National Provider Directory
Locations
202 W Montgomery St
Gaffney, SC 29341
Phone (864) 487-2142
1115 N Logan St
Gaffney, SC 29341
Phone (864) 487-2142
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | SC | Yes |
Addresses
Primary practice location
1115 N Logan St
Gaffney, SC 29341-2022
Mailing address
PO Box 88
Gaffney, SC 29342-0088
Phone (864) 487-2142
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DE2014 | Medicaid | SC |
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- Manzoor Ahmad
- Caprice Y. Alexander
- Alfred Randall Moss MD PA
- Alfred Randall Moss MD PA
- Anecia Dishel Allen
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All providers in Gaffney, SC · Durable Medical Equipment & Medical Supplies 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 Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.