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Organization

MOON'S HOME MEDICAL

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JERRY L SMITH RPH (OWNER)
(864) 647-8770
Entity
Organization

Contact information

Practice address
134 E MAIN ST, WESTMINSTER, SC 29693-1753
(864) 647-8770
(864) 647-2906
Mailing address
134 E MAIN ST, WESTMINSTER, SC 29693-1753
(864) 647-8770
(864) 647-2906

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
DME236
SC
Enumeration date
01/23/2007
Last updated
08/22/2020
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