Organization
LIVEWELL MEDICAL INC
Active
Parent organization
LIVEWELL MEDICAL INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
LIVEWELL MEDICAL INC
Authorized official
MR. SCOTT STALEY (PRESIDENT)
(704) 494-8849
Entity
Organization
Contact information
Practice address
7530 WHITE HORSE ROAD, UNIT C, GREENVILLE, SC 29611-2000
(864) 246-5075
(864) 246-5085
Mailing address
8421 OLD STATESVILLE RD, SUITE 18, CHARLOTTE, NC 28269-1808
(704) 494-8849
(704) 494-8850
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
332BC3200X
Customized Equipment (DME)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7705314
—
NC
05
—
DE3234
—
SC
Enumeration date
08/14/2008
Last updated
05/09/2012
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