Individual ProviderVickery M. SmithDurable Medical Equipment & Medical SuppliesSuppliersPractice Address15 Mallard St, Greenville, SC 29601-3309(864) 242-9984PECOS EnrollmentBased on the most recent information from CMS, provider Vickery M. Smith does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 11:47 AM.Profile DetailsProvider ID1083794275Provider TypeIndividualFull NameSmith, Vickery M.GenderMaleSole ProprietorYesEnumeration Date10/16/2006Last Updated7/8/2007Contact InformationPractice LocationPractice Address15 Mallard St, Greenville, SC 29601-3309Phone(864) 242-9984Fax(864) 242-2226Mailing LocationMailing Address15 Mallard St, Greenville, SC 29601-3309Phone(864) 242-9984Fax(864) 242-2226Provider TaxonomiesCodeDescriptionLicenseCode332B00000XPrimaryDescriptionDurable Medical Equipment & Medical SuppliesSuppliersLicense202418097South CarolinaProvider IdentifiersIDDescriptionIssuerIDDE2605DescriptionMedicaidIssuerUnlistedSouth Carolina