Provider Demographics
NPI:1427239169
Name:UNIVERSITY MEDICAL SERVICES & SUPPL
Entity type:Organization
Organization Name:UNIVERSITY MEDICAL SERVICES & SUPPL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ALFRED
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:MCFARLIN
Authorized Official - Suffix:JR
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:803-319-1805
Mailing Address - Street 1:PO BOX 2734
Mailing Address - Street 2:
Mailing Address - City:WEST COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29171-2734
Mailing Address - Country:US
Mailing Address - Phone:803-319-1805
Mailing Address - Fax:803-796-9320
Practice Address - Street 1:6941 NORTH TRENHOLM ROAD SUITE 0-103
Practice Address - Street 2:PINNACLE PROFESSIONAL PARK
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29206-1729
Practice Address - Country:US
Practice Address - Phone:803-782-0761
Practice Address - Fax:803-782-0762
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-23
Last Update Date:2008-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC040 70930 4332BN1400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCDE3099Medicaid
SCDE3099Medicaid