Organization
KIDS CARE MEDICAL
Active
Other names
Family Care Medical
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH C DRAKE (OWNER)
(843) 915-0173
Entity
Organization
Contact information
Practice address
202 SHERWOOD DRIVE, CONWAY, SC 29526
(843) 915-0173
(843) 410-6364
Mailing address
POST OFFICE BOX 1196, CONWAY, SC 29528
(843) 915-0173
(843) 410-6364
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
026544204
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7703904
—
SC
05
—
DE2406
—
SC
Enumeration date
01/05/2006
Last updated
06/11/2019
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