1750559373 NPI number — LOWCOUNTRY HAND CENTER, PC

Table of content: (NPI 1750559373)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750559373 NPI number — LOWCOUNTRY HAND CENTER, PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LOWCOUNTRY HAND CENTER, PC
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:
1750559373
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/21/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2881 TRICOM ST
Provider Second Line Business Mailing Address:
SUITE A
Provider Business Mailing Address City Name:
N CHARLESTON
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29406-9823
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
843-572-0444
Provider Business Mailing Address Fax Number:
843-302-0644

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2881 TRICOM ST
Provider Second Line Business Practice Location Address:
SUITE A
Provider Business Practice Location Address City Name:
N CHARLESTON
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29406-9823
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
843-572-0444
Provider Business Practice Location Address Fax Number:
843-302-0644
Provider Enumeration Date:
02/16/2008

Additional Information

Authorized Official

Authorized Official Last Name:
ALLEN
Authorized Official First Name:
TIMOTHY
Authorized Official Middle Name:
GRAHAM
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
843-729-0681

Provider Taxonomy Codes

  • Taxonomy code: 207XS0106X , with the licence number:  23735 , 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: 1750559373 . This is a "NPPES" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".
  • Identifier: 20076842 . This is a "SELECT HEALTH" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com