Organization
MED FOUR LLC
Active
Organization
MED FOUR LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES THOMPSON (PRESIDENT)
(864) 370-3529
Entity
Organization
Contact information
Practice address
3555 RUTHERFORD RD, TAYLORS, SC 29687-2167
(864) 370-3529
(864) 370-3256
Mailing address
3555 RUTHERFORD RD, TAYLORS, SC 29687-2167
(864) 370-3529
(864) 370-3256
Taxonomy
Speciality
Code
Description
License number
State
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
Primary
50-005844
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
751275
—
SC
05
—
DE1681
—
SC
Enumeration date
07/12/2005
Last updated
08/22/2020
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