Organization
EMILY A STACKS
Active
Other names
Diabetic Supply Providers
Organization subpart
No
Provider details
NPI number
Authorized official
MS. EMILY STACKS (OWNER)
(803) 283-0870
Entity
Organization
Contact information
Practice address
503 SHORELINE DR, LANCASTER, SC 29720-6006
(803) 283-0870
(803) 283-3387
Mailing address
503 SHORELINE DR, LANCASTER, SC 29720-6006
(803) 283-0870
(803) 283-3387
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DM0797
—
SC
Enumeration date
01/29/2008
Last updated
11/15/2011
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