Provider Demographics
NPI:1447352646
Name:BIO-MEDICAL APPLICATIONS OF SOUTH CAROLINA, INC.
Entity type:Organization
Organization Name:BIO-MEDICAL APPLICATIONS OF SOUTH CAROLINA, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:FAWCETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-402-9000
Mailing Address - Street 1:WINNSBORO BI-LO SHOPPING CENTER
Mailing Address - Street 2:1126 US HIGHWAY, 321 BUSINESS SOUTH, SUITE A
Mailing Address - City:WINNSBORO
Mailing Address - State:SC
Mailing Address - Zip Code:29180
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:WINNSBORO BI-LO SHOPPING CENTER
Practice Address - Street 2:1126 US HIGHWAY, 321 BUSINESS SOUTH, SUITE A
Practice Address - City:WINNSBORO
Practice Address - State:SC
Practice Address - Zip Code:29180
Practice Address - Country:US
Practice Address - Phone:803-712-6732
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment
Provider Identifiers
StateIdentifier IDID TypeIssuer
422581Medicare ID - Type Unspecified