Eytaw Medical Supply LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

EYTAW MEDICAL SUPPLY LLC

Practice address

505 N Highway 52
Ste D 103
Moncks Corner, SC 29461-3151

Phone

(803) 614-9023

NPI assigned

Aug 3, 2015

Organization subpart

No

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

Authorized official

Name

Tony Benet

Title

Manager

Phone

(803) 614-9023

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1438560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438560000000",
    "number": "1831575703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 N HIGHWAY 52",
            "address_2": "STE D 103",
            "city": "MONCKS CORNER",
            "state": "SC",
            "postal_code": "294613151",
            "telephone_number": "803-614-9023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 N HIGHWAY 52",
            "address_2": "STE D 103",
            "city": "MONCKS CORNER",
            "state": "SC",
            "postal_code": "294613151",
            "telephone_number": "803-614-9023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYTAW MEDICAL SUPPLY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-03",
        "last_updated": "2015-08-03",
        "status": "A",
        "authorized_official_last_name": "BENET",
        "authorized_official_first_name": "TONY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "803-614-9023"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Moncks Corner, SC
• Providers in Moncks Corner, 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 3, 2015; 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.