Organization
ADAPTIVE MEDICAL UPSTATE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GREG TUCKER (PRESIDENT)
(864) 472-5541
Entity
Organization
Contact information
Practice address
48 LAWRENCE ST, LYMAN, SC 29365-1637
(864) 472-5541
(864) 472-5564
Mailing address
48 LAWRENCE ST, LYMAN, SC 29365-1637
(864) 472-5541
(864) 472-5564
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DME817
—
SC
Enumeration date
08/31/2006
Last updated
08/22/2020
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