1003910746 NPI number — MRS. SUZANNE BROOKE STARKEY PT OCS

Table of content: MRS. SUZANNE BROOKE STARKEY PT OCS (NPI 1003910746)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003910746 NPI number — MRS. SUZANNE BROOKE STARKEY PT OCS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
STARKEY
Provider First Name:
SUZANNE
Provider Middle Name:
BROOKE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
PT OCS
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BROOKE
Provider Other First Name:
SUZANNE
Provider Other Middle Name:
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1003910746
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/06/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
71 GABLES LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BLUFFTON
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29910-7838
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
843-757-0244
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1525 CHAPIN RD
Provider Second Line Business Practice Location Address:
CHAPIN REHABILITATION CLINIC INC
Provider Business Practice Location Address City Name:
CHAPIN
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29036-0337
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
803-345-3811
Provider Business Practice Location Address Fax Number:
803-345-3018
Provider Enumeration Date:
09/12/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  4181 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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