Med Four LLC

Primary specialty

Parenteral & Enteral Nutrition Supplies (DME)Taxonomy code 332BP3500X

License

50-005844 Issued in SC

Legal business name

MED FOUR LLC

Practice address

3555 Rutherford Rd
Taylors, SC 29687-2167

Phone

(864) 370-3529

Fax

(864) 370-3256

NPI assigned

Jul 12, 2005

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Charles Thompson

Title

President

Phone

(864) 370-3529

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1121126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1932107075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3555 RUTHERFORD RD",
            "city": "TAYLORS",
            "state": "SC",
            "postal_code": "296872167",
            "telephone_number": "864-370-3529",
            "fax_number": "864-370-3256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3555 RUTHERFORD RD",
            "city": "TAYLORS",
            "state": "SC",
            "postal_code": "296872167",
            "telephone_number": "864-370-3529",
            "fax_number": "864-370-3256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MED FOUR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "864-370-3529",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": "SC",
            "license": "50-005844",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DE1681",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "751275",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elysa Maunder
• Latoya McCombs- Martin, APRN
• Madison Mace McCraw, FNP-C
• Rebekka McDonald
• William McDonald, LPC-A
• Mobile Radiology & Ekg of Carolina, Inc. (RADS Mobile X-ray or RADS Mobile X-ray & Digital Imaging)
• Casey Lynn Moore, MS, SCAT, ATC
• David H. Mruz, D.C.
• Victoria Myers, RD/N
• National Vision, Inc.

• Parenteral & Enteral Nutrition Supplies (DME) in Taylors, SC
• Providers in Taylors, SC by specialty
• Parenteral & Enteral Nutrition Supplies (DME) in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.