Organization Active NPI

Tucker-Wells Medical, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Florence, SC
National Provider Identifier
1487663878
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
TUCKER-WELLS MEDICAL, INC.
Practice address
198 E Cheves St
Florence, SC 29506-2599
Phone
(843) 665-2092
Fax
(843) 665-5205
NPI assigned
Aug 5, 2006
Last updated
Apr 20, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

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

Authorized official

Name
Robert Ken Wells
Title
Owner
Phone
(843) 665-2092

Specialties & licenses 1

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

Addresses

Primary practice location

198 E Cheves St
Florence, SC 29506-2599

Mailing address

198 E Cheves St
Florence, SC 29506-2599
Phone (843) 665-2092

Other identifiers 1

IdentifierTypeStateIssuer
DE2796MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930067675 SC DME Supplier - Medical Supply CompanyDME Supplier - Oxygen & Equipment 1153524350 Practice locations: Florence, SC

National Provider Directory

National Provider Directory
Tax ID family
Tucker-Wells Medical Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1487663878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "198 E CHEVES ST",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295062599",
            "telephone_number": "843-665-2092",
            "fax_number": "843-665-5205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "198 E CHEVES ST",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295062599",
            "telephone_number": "843-665-2092",
            "fax_number": "843-665-5205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TUCKER-WELLS MEDICAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-05",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "WELLS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "KEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-665-2092"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DE2796",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Florence, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.