1356444764 NPI number — MARGARET F CURTIS

Table of content: MR. DANIEL MODELL BODKIN P.T. (NPI 1649494378)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356444764 NPI number — MARGARET F CURTIS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MARGARET F CURTIS
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:
6
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:
1356444764
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/27/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1857
Provider Second Line Business Mailing Address:
90 W WILSON STREET
Provider Business Mailing Address City Name:
RIDGELAND
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29936-2631
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
843-717-2600
Provider Business Mailing Address Fax Number:
843-717-2356

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
90 W WILSON STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RIDGELAND
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29936-8724
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
843-717-2600
Provider Business Practice Location Address Fax Number:
843-717-2356
Provider Enumeration Date:
09/07/2006

Additional Information

Authorized Official

Authorized Official Last Name:
CURTIS
Authorized Official First Name:
MARGARET
Authorized Official Middle Name:
F
Authorized Official Title or Position:
SOLE PROPRIETOR
Authorized Official Telephone Number:
843-717-2600

Provider Taxonomy Codes

  • Taxonomy code: 261QR1300X , with the licence number:  00011522 , 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)

  • Identifier: RHC114 , issued by the state of ( SC ) . This identifiers is of the category "MEDICAID".




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