Organization
SILVA ENTERPRISES LLC
Active
Other names
MEDISOURCE HOME MEDICAL
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SERGIO SILVA (OWNER)
(803) 532-2644
Entity
Organization
Contact information
Practice address
110 MAIN ST, LEESVILLE, SC 29070-8016
(803) 532-2644
(803) 532-2644
Mailing address
110 MAIN ST, LEESVILLE, SC 29070-8016
(803) 532-2644
(803) 532-2644
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
032352588
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DE1997
—
SC
Enumeration date
07/18/2006
Last updated
04/25/2011
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