Organization
MEDICINE MAN MEDICAL SUPPLIES AND EQUIPMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELE A MISSROON (MANAGER/OWNER)
(843) 871-6944
Entity
Organization
Contact information
Practice address
404 OLD TROLLEY RD, SUMMERVILLE, SC 29485-5661
(843) 871-6944
(843) 871-9749
Mailing address
404 OLD TROLLEY RD, SUMMERVILLE, SC 29485-5661
(843) 871-6944
(843) 871-9749
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
SC
332BX2000X
Oxygen Equipment & Supplies (DME)
—
SC
Other
Enumeration date
10/11/2006
Last updated
09/11/2025
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