Provider Demographics
NPI:1235665928
Name:ST. GEORGE HOME MEDI, LLC
Entity type:Organization
Organization Name:ST. GEORGE HOME MEDI, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:JASON
Authorized Official - Last Name:BARTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-563-8949
Mailing Address - Street 1:141 N PARLER AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT GEORGE
Mailing Address - State:SC
Mailing Address - Zip Code:29477-2221
Mailing Address - Country:US
Mailing Address - Phone:843-563-8949
Mailing Address - Fax:843-563-8954
Practice Address - Street 1:141 N PARLER AVE
Practice Address - Street 2:
Practice Address - City:SAINT GEORGE
Practice Address - State:SC
Practice Address - Zip Code:29477-2221
Practice Address - Country:US
Practice Address - Phone:843-563-8949
Practice Address - Fax:843-563-8954
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-02
Last Update Date:2017-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies