1366631046 NPI number — CHARLESTON HYPERBARIC MEDICINE INC.

Table of content: (NPI 1366631046)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1366631046 NPI number — CHARLESTON HYPERBARIC MEDICINE INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CHARLESTON HYPERBARIC MEDICINE 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:
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:
1366631046
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 146
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LADSON
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29456-0146
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
843-572-8050
Provider Business Mailing Address Fax Number:
843-569-2281

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9231 MEDICAL PLAZA DR
Provider Second Line Business Practice Location Address:
SUITE C
Provider Business Practice Location Address City Name:
NORTH CHARLESTON
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29406-9101
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
843-572-8050
Provider Business Practice Location Address Fax Number:
843-569-2281
Provider Enumeration Date:
10/18/2007

Additional Information

Authorized Official

Authorized Official Last Name:
PEERY
Authorized Official First Name:
ELAINE
Authorized Official Middle Name:
DEVLIN
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
843-572-8050

Provider Taxonomy Codes

  • Taxonomy code: 261QM2500X , 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)





Copyright © 2007-2025 www.npivalidator.com