NPIMap

Organization Active NPI

Convacare, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Chester, SC
National Provider Identifier
1376633016
Registry record updated Jun 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
01207563 Issued in SC
Legal business name
CONVACARE, INC.
Practice address
249C Columbia St
Chester, SC 29706-2017
Phone
(803) 581-2313
NPI assigned
Oct 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2009

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

Authorized official

Name
Mr. Edward P. Hammond
Title
Owner
Phone
(803) 581-2313

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 01207563 SC Primary

Addresses

Primary practice location

249C Columbia St
Chester, SC 29706-2017

Mailing address

PO Box 2235
Irmo, SC 29063-7235
Phone (803) 581-2313

Other identifiers 1

IdentifierTypeStateIssuer
561895MedicaidSC

National Provider Directory

National Provider Directory

Locations

249C Columbia St
Chester, SC 29706
Phone (803) 581-2313

NPI Registry JSON

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1244505600000",
    "number": "1376633016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2235",
            "city": "IRMO",
            "state": "SC",
            "postal_code": "290637235",
            "telephone_number": "803-581-2313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "249C COLUMBIA ST",
            "city": "CHESTER",
            "state": "SC",
            "postal_code": "297062017",
            "telephone_number": "803-581-2313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONVACARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-13",
        "last_updated": "2009-06-09",
        "status": "A",
        "authorized_official_last_name": "HAMMOND",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "803-581-2313",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "SC",
            "license": "01207563",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "561895",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chester, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2009; 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.