Medsource Medical DME LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

MEDSOURCE MEDICAL DME LLC

Practice address

320 Midland Pkwy
Ste B
Summerville, SC 29485-7197

Phone

(843) 906-5020

Fax

(843) 970-8055

NPI assigned

Apr 18, 2008

Organization subpart

No

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

Authorized official

Name

Mrs. Melinda Campbell Dingle

Title

President

Phone

(843) 906-5020

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Medsource Medical DME LLC Doing business as

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Beatrice J Hull, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Charleston, SC
  • NPI 1396832382
  NPD (past)
• Eveline Adams Waring, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • North Charleston, SC
  • NPI 1295973873
  NPD (past)

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

{
    "created_epoch": "1208476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628726400000",
    "number": "1508030743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2831 TRICOM ST STE A",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "29406",
            "telephone_number": "843-906-5020",
            "fax_number": "843-297-4154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 MIDLAND PKWY",
            "address_2": "STE B",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294857197",
            "telephone_number": "843-906-5020",
            "fax_number": "843-970-8055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDSOURCE MEDICAL DME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-18",
        "last_updated": "2021-08-12",
        "certification_date": "2021-08-12",
        "status": "A",
        "authorized_official_last_name": "DINGLE",
        "authorized_official_first_name": "MELINDA",
        "authorized_official_middle_name": "CAMPBELL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "843-906-5020",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "SC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DE2428",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medsource Medical DME LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Medsource Medical DME LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Olivia G Medders
• Medical Outreach Clinic of Summerville Inc
• Medicine Man Medical Supplies and Equipment
• Sasha Medina, M.ED
• Medprimary LLC
• Meduport Transportations
• Riley Mehaffey, DC
• Jessica Melendez
• Barbara Melton, M.ED., LPC
• Miguel Mendoza Tinoco, PHARMD

• Durable Medical Equipment & Medical Supplies in Summerville, SC
• Providers in Summerville, 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 Aug 12, 2021; 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.