Organization
MID-CAROLINA MEDICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HANK BENJAMIN GOFF (OWNER)
(803) 408-2858
Entity
Organization
Contact information
Practice address
2465 MAIN ST, SUITE C, ELGIN, SC 29045-8833
(803) 408-2858
(803) 408-2874
Mailing address
2465 MAIN ST, SUITE C, ELGIN, SC 29045-8833
(803) 408-2858
(803) 408-2874
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DE2710
—
SC
Enumeration date
05/01/2006
Last updated
07/17/2007
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