Organization
UPSTATE MEDICAL SUPPLY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC R ROHDE (MANAGING MEMBER)
(864) 429-4507
Entity
Organization
Contact information
Practice address
408 N DUNCAN BYP STE D&E, UNION, SC 29379-8663
(864) 429-4507
(864) 429-4597
Mailing address
408 N DUNCAN BYPASS, STE E-5 BOX 13, UNION, SC 29379
(864) 429-4507
(864) 429-4597
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
044063878
SC
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DE2751
—
SC
Enumeration date
07/08/2006
Last updated
12/04/2024
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