360 Durable Medical Supplies & Equipment

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

360 DURABLE MEDICAL SUPPLIES & EQUIPMENT

Practice address

1314 N Main St Ste D
Fountain Inn, SC 29644-1332

Phone

(864) 625-3252

NPI assigned

Oct 19, 2020

Organization subpart

No

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

Authorized official

Name

Michael Anthony Wallace

Title

Ceo

Phone

(864) 625-3252

Specialties & licenses 1

Addresses

Other names 1

• 360 DURABLE MEDICAL SUPPLIES & EQUIPMENT Doing business as

Locations

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

{
    "created_epoch": "1603065600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603065600000",
    "number": "1457950875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1314 N MAIN ST STE D",
            "city": "FOUNTAIN INN",
            "state": "SC",
            "postal_code": "296441332",
            "telephone_number": "864-625-3252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1314 N MAIN ST STE D",
            "city": "FOUNTAIN INN",
            "state": "SC",
            "postal_code": "296441332",
            "telephone_number": "864-625-3252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "360 DURABLE MEDICAL SUPPLIES & EQUIPMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-19",
        "last_updated": "2020-10-19",
        "certification_date": "2020-10-19",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "864-625-3252"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "360 DURABLE MEDICAL SUPPLIES & EQUIPMENT",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Fountain Inn, SC
• 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 Oct 19, 2020; 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.