OTIS BOYD GARDO JR NPI 1093983215

NPI Information

NPI: 1093983215
Provider Name: OTIS BOYD GARDO JR

Doing Business As: HIGHLANDS ANAPLASTOLOGY ASSOCIATES

Classification: Durable Medical Equipment & Medical Supplies - 332BC3200X
Entity Type: Organization

Specialization: Customized Equipment

Address:
1007 GROVE RD
SUITE E
GREENVILLE, SC
ZIP 29605
Phone: (864) 232-3008
Get Directions

OTIS BOYD GARDO JR is a customized equipment durable medical equipment medical supplies in Greenville, SC. OTIS BOYD GARDO JR NPI is 1093983215. The provider is registered as an organization entity type.
The provider Is Doing Business As Highlands Anaplastology Associates.

The provider's business location address is:

1007 GROVE RD
SUITE E
GREENVILLE, SC
ZIP 29605-630
Phone: (864) 232-3008
Fax: (864) 845-8556

The provider's authorized official is Rebecca J. Gardo .
The authorized official title is Office Manager and has the following contact phone number (864) 232-3008.

The enumeration date for this NPI number is 2/11/2008 and was last updated on 2/3/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	332BC3200X	Durable Medical Equipment & Medical Supplies	Customized Equipment			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	DE2711	MEDICAID	SOUTH CAROLINA
2	4860940001	MEDICARE NSC	SOUTH CAROLINA
3	=========	OTHER		HEALTH CARE SAVINGS
4	=========	OTHER		BCBS
5	=========	OTHER		TRICARE
6	7704873	MEDICAID	NORTH CAROLINA
7	530923946B	MEDICAID	GEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »