Organization
BLACK RIVER MEDICAL SUPPLIES AND EQUIPMENT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICKIE B MITCHELL BA (CO-OWNER)
(843) 355-5545
Entity
Organization
Contact information
Practice address
482 NELSON BLVD, KINGSTREE, SC 29556-4025
(843) 355-5545
(843) 355-5546
Mailing address
482 NELSON BLVD, KINGSTREE, SC 29556-4025
(843) 355-5545
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
—
—
Other
Enumeration date
03/09/2022
Last updated
01/03/2023
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