Organization
ILDERTON CONVERSION CO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LINDA ILDERTON (OWNER)
(843) 576-0414
Entity
Organization
Contact information
Practice address
8550 RIVERS AVE, NORTH CHARLESTON, SC 29406-9207
(843) 576-0414
Mailing address
8550 RIVERS AVE, NORTH CHARLESTON, SC 29406-9207
(843) 576-0414
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Enumeration date
06/14/2013
Last updated
06/14/2013
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