1831114735 NPI number — NEW HOPE CAROLINAS

Table of content: (NPI 1831114735)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831114735 NPI number — NEW HOPE CAROLINAS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NEW HOPE CAROLINAS
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:
1831114735
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/21/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7515 NORTHSIDE DR
Provider Second Line Business Mailing Address:
SUITE 200
Provider Business Mailing Address City Name:
NORTH CHARLESTON
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29420-4283
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
843-572-3498
Provider Business Mailing Address Fax Number:
843-574-9394

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
101 SEDGEWOOD DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ROCK HILL
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29732-2315
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
803-328-9300
Provider Business Practice Location Address Fax Number:
803-328-0102
Provider Enumeration Date:
07/12/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BARE
Authorized Official First Name:
SUSAN
Authorized Official Middle Name:
Authorized Official Title or Position:
ASST CONTROLLER
Authorized Official Telephone Number:
843-572-3498

Provider Taxonomy Codes

  • Taxonomy code: 323P00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 942MXH , issued by the state of ( SC ) . This identifiers is of the category "MEDICAID".
  • Identifier: RTF-032 , issued by the state of ( SC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 036315800 , issued by the state of ( DC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3404518 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 010432200 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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