Active NPI
Tucker-Wells Medical, Inc.
- Durable Medical Equipment & Medical Supplies
- Florence, SC
National Provider Identifier
1487663878
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Durable Medical Equipment & Medical Supplies
- 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, 2008
- Organization subpart
- No
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DE2796 | Medicaid | SC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930067675 | SC | DME Supplier - Medical Supply Company | 1153524350 | Practice locations: Florence, SC |
National Provider Directory
National Provider Directory- Tax ID family
- Tucker-Wells Medical Inc
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Durable Medical Equipment & Medical Supplies
- Florence, SC
- NPI 1881891976
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.