Organization
ADVENT MEDICAL SUPPLIES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT BRIAN BOURONICH COF (CEO/OWNER)
(843) 597-2264
Entity
Organization
Contact information
Practice address
1223 REMOUNT RD., NORTH CHARLESTON, SC 29406-3418
(843) 277-0077
(803) 753-9699
Mailing address
1223 REMOUNT RD., NORTH CHARLESTON, SC 29406-3418
(843) 277-0077
(803) 753-9699
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30130241
—
SC
01
—
C53596
CERTIFIED ORTHOTIC FITTER LICENSE
—
01
—
S1381
BOC ACCREDITATION NUMBER
—
Enumeration date
01/13/2010
Last updated
06/23/2021
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