| Southeast Maternal Medical Supply Inc | |
|
14323 Ocean Hwy Unit 4103 Pawleys Island SC 29585-4817 | |
| (843) 310-4650 | |
| Not Available |
| Full Name | Southeast Maternal Medical Supply Inc |
|---|---|
| Speciality | Counselor |
| Location | 14323 Ocean Hwy Unit 4103, Pawleys Island, South Carolina |
| Authorized Official Name and Position | Julee Krechel (PRESIDENT) |
| Authorized Official Contact | 8433104650 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southeast Maternal Medical Supply Inc Po Box 2036 Pawleys Island SC 29585-2036 Ph: (843) 310-4650 | Southeast Maternal Medical Supply Inc 14323 Ocean Hwy Unit 4103 Pawleys Island SC 29585-4817 Ph: (843) 310-4650 |
| NPI Number | 1093121493 |
|---|---|
| Provider Enumeration Date | 07/07/2014 |
| Last Update Date | 09/24/2024 |
| Certification Date | 09/24/2024 |
| Medicare PECOS PAC ID | 4587190731 |
|---|---|
| Medicare Enrollment ID | O20241211001034 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093121493 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 4649 (South Carolina) | Primary |
| 174N00000X | Lactation Consultant, Non-rn | L-49698 (South Carolina) | Secondary |
| Provider Name | Grace Ellen Krechel |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1740213818 PECOS PAC ID: 1759817901 Enrollment ID: I20241211001153 |
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