1235325242 NPI number — NEW BEGINNINGS OF CHARLESTON INC.

Table of content: (NPI 1235325242)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235325242 NPI number — NEW BEGINNINGS OF CHARLESTON INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NEW BEGINNINGS OF CHARLESTON INC.
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:
1235325242
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/24/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 50668
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SUMMERVILLE
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29485-0668
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
843-207-9827
Provider Business Mailing Address Fax Number:
843-207-1705

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
716 W FRONT ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LINCOLNVILLE
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29485-7112
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
843-832-1086
Provider Business Practice Location Address Fax Number:
843-832-1086
Provider Enumeration Date:
09/24/2007

Additional Information

Authorized Official

Authorized Official Last Name:
GREER
Authorized Official First Name:
RUTH
Authorized Official Middle Name:
ANN
Authorized Official Title or Position:
PROGRAM COORDINATOR
Authorized Official Telephone Number:
843-343-6136

Provider Taxonomy Codes

  • Taxonomy code: 322D00000X , with the licence number:  SR-0005293001-GH , 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: 913MXH , issued by the state of ( SC ) . This identifiers is of the category "MEDICAID".




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