Blu Bird Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

00071953 Issued in SC

Legal business name

BLU BIRD INC

Practice address

711 Harry Raysor Dr
Saint Matthews, SC 29135

Phone

(803) 874-4369

Fax

(803) 874-1772

NPI assigned

Dec 13, 2006

Last updated

Dec 28, 2007By 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

Mrs. Amy Peterkin Conger

Title

President

Phone

(803) 874-4369

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198800000000",
    "number": "1316008394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 HARRY RAYSOR DR",
            "city": "SAINT MATTHEWS",
            "state": "SC",
            "postal_code": "29135",
            "telephone_number": "803-874-4369",
            "fax_number": "803-874-1772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 HARRY RAYSOR DR",
            "city": "SAINT MATTHEWS",
            "state": "SC",
            "postal_code": "29135",
            "telephone_number": "803-874-4369",
            "fax_number": "803-874-1772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLU BIRD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-13",
        "last_updated": "2007-12-28",
        "status": "A",
        "authorized_official_last_name": "CONGER",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "PETERKIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "803-874-4369",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "SC",
            "license": "00071953",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DE1411",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Calhoun County Disabilities and Special Needs Board
• Calhoun County High School

• Durable Medical Equipment & Medical Supplies in St Matthews, SC
• Providers in St Matthews, 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 Dec 28, 2007; 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.