Pee Dee Home Medical Supply Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

PEE DEE HOME MEDICAL SUPPLY INC

Practice address

801A Highway 301 N Unit a
Dillon, SC 29536-2450

Phone

(843) 841-9003

Fax

(843) 841-9736

NPI assigned

Apr 21, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Carl Altman

Title

Owner

Phone

(843) 841-9003

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Tax ID family

Pee Dee Family Pharmacy3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Pee Dee Family Pharmacy

  dba Pee Dee Home Med Supply and Pharmacy

  • Community/Retail Pharmacy
  • Dillon, SC
  • NPI 1215007398
  NPD tax ID
• Pee Dee Home Medical Supply

  • Oxygen Equipment & Supplies (DME)
  • Dillon, SC
  • NPI 1366822512
  NPD tax ID

Locations

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

{
    "created_epoch": "1145577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434931200000",
    "number": "1548226343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 HIGHWAY 301 N UNIT A",
            "city": "DILLON",
            "state": "SC",
            "postal_code": "295362467",
            "telephone_number": "843-841-9003",
            "fax_number": "843-841-9736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801A HIGHWAY 301 N UNIT A",
            "city": "DILLON",
            "state": "SC",
            "postal_code": "295362450",
            "telephone_number": "843-841-9003",
            "fax_number": "843-841-9736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEE DEE HOME MEDICAL SUPPLY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-21",
        "last_updated": "2015-06-22",
        "status": "A",
        "authorized_official_last_name": "ALTMAN",
        "authorized_official_first_name": "CARL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-841-9003",
        "authorized_official_name_prefix": "Mr."
    },
    "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": "7703296",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SELECT HEALTH MEDICAID",
            "identifier": "20003624",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DE1854",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Peace of Mind Home Care Assistance LLC
• Pee Dee Family Pharmacy (Pee Dee Home Med Supply and Pharmacy)
• Pee Dee Health Care, Inc.
• Pee Dee Health Solutions PC
• Pee Dee Home Medical Supply
• Pernell Family Services LLC
• Pernell Family Services LLC
• Kerria Pernell
• Michael Pernell
• Teresa Y Pernell

• Durable Medical Equipment & Medical Supplies in Dillon, SC
• Providers in Dillon, 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 Jun 22, 2015; 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.