1326808841 NPI number — CHARLESTON HAND THERAPY CENTER

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326808841 NPI number — CHARLESTON HAND THERAPY CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CHARLESTON HAND THERAPY CENTER
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1326808841
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/21/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1483 TOBIAS GADSON BLVD STE 205B
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHARLESTON
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29407-4641
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
843-766-6494
Provider Business Mailing Address Fax Number:
843-766-6495

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
325 FOLLY RD RM 230
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHARLESTON
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29412-2507
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
843-766-6494
Provider Business Practice Location Address Fax Number:
843-766-6495
Provider Enumeration Date:
03/21/2024

Additional Information

Authorized Official

Authorized Official Last Name:
JUSTICE
Authorized Official First Name:
LAURA
Authorized Official Middle Name:
JEAN
Authorized Official Title or Position:
OFFICE MANAGER
Authorized Official Telephone Number:
843-766-6494

Provider Taxonomy Codes

  • Taxonomy code: 225XH1200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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