Organization
THE SPORTS MEDICINE SHOP, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER JEANNE SMITH (VP OPERATIONS)
(864) 760-0909
Entity
Organization
Contact information
Practice address
1205 ELLA ST STE A, ANDERSON, SC 29621-4811
(864) 760-0909
(866) 594-2740
Mailing address
1205 ELLA ST STE A, ANDERSON, SC 29621-4811
(864) 760-0909
(866) 594-2740
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DE3476
—
SC
Enumeration date
02/15/2012
Last updated
05/14/2026
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