1649530502 NPI number — NEW BEGINNINGS FAMILY SERVICES

Table of content: SUSAN CHASE HOGAN AU.D. (NPI 1467403428)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649530502 NPI number — NEW BEGINNINGS FAMILY SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NEW BEGINNINGS FAMILY SERVICES
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:
1649530502
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/06/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 11956
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COLUMBIA
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29211-1956
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
803-748-8885
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1000 12TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CAYCE
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29033-3303
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
803-748-8885
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/24/2012

Additional Information

Authorized Official

Authorized Official Last Name:
JACKSON
Authorized Official First Name:
EDWINA
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
803-748-8885

Provider Taxonomy Codes

  • Taxonomy code: 251C00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2024 www.npivalidator.com