Southeastern Medical Supply Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

1386679009 Issued in SC

Legal business name

SOUTHEASTERN MEDICAL SUPPLY INC

Practice address

1024 Wildwood Centre Dr
Suite a
Columbia, SC 29229-8400

Phone

(803) 233-3691

Fax

(803) 233-6140

NPI assigned

Jul 11, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Mary E Nodelman

Title

Secretary/Insurance Coordinator

Phone

(803) 233-3691

Specialties & licenses 1

Addresses

Other names 1

• SE Medical Supply Other name

Locations

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1227139200000",
    "number": "1386679009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1024 WILDWOOD CENTRE DR",
            "address_2": "SUITE A",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292298400",
            "telephone_number": "803-233-3691",
            "fax_number": "803-233-6140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1024 WILDWOOD CENTRE DR",
            "address_2": "SUITE A",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292298400",
            "telephone_number": "803-233-3691",
            "fax_number": "803-233-6140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEASTERN MEDICAL SUPPLY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-11",
        "last_updated": "2008-11-20",
        "status": "A",
        "authorized_official_last_name": "NODELMAN",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "SECRETARY/INSURANCE COORDINATOR",
        "authorized_official_telephone_number": "803-233-3691",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "SC",
            "license": "1386679009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SE Medical Supply",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Durable Medical Equipment & Medical Supplies in Columbia, SC
• Providers in Columbia, 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 Nov 20, 2008; 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.