Organization
COASTAL REHAB & SUPPLY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSEPH W PEARSON (OWNER)
(864) 241-4030
Entity
Organization
Contact information
Practice address
1158 RUTHERFORD RD, GREENVILLE, SC 29609-3927
(864) 241-4030
(864) 282-0990
Mailing address
1158 RUTHERFORD RD, GREENVILLE, SC 29609-3927
(864) 241-4030
(864) 282-0990
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
SC
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DE2426
—
SC
Enumeration date
04/26/2006
Last updated
07/21/2022
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