Organization
DISTINGUISHED CROWNS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANZIA TIMMONS WALLACE (OWNER)
(843) 624-0373
Entity
Organization
Contact information
Practice address
4001 E PALMETTO ST STE 1305, FLORENCE, SC 29506-4213
(843) 624-0373
Mailing address
PO BOX 12176, FLORENCE, SC 29504-2176
(843) 624-0373
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Enumeration date
04/05/2021
Last updated
09/03/2021
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