1376546788 NPI number — CHARLESTON COUNTY GOVERNMENT

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1376546788 NPI number — CHARLESTON COUNTY GOVERNMENT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CHARLESTON COUNTY GOVERNMENT
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:
1376546788
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/12/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 100112
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:
29202-3112
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
843-202-3722
Provider Business Mailing Address Fax Number:
888-965-4620

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4045 BRIDGE VIEW DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORTH CHARLESTON
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29405-7464
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
843-202-6722
Provider Business Practice Location Address Fax Number:
843-202-6712
Provider Enumeration Date:
05/31/2005

Additional Information

Authorized Official

Authorized Official Last Name:
MILLER
Authorized Official First Name:
JENNIFER
Authorized Official Middle Name:
Authorized Official Title or Position:
COUNTY ADMINISTRATOR
Authorized Official Telephone Number:
843-202-6712

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  0015 , 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: 501996 , issued by the state of ( SC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 601154 , issued by the state of ( SC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 018075300 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com