1609592955 NPI number — MRS. DORIS LORRAINE HARDEE ABOC, NCLE, LDO

Table of content: MRS. DORIS LORRAINE HARDEE ABOC, NCLE, LDO (NPI 1609592955)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609592955 NPI number — MRS. DORIS LORRAINE HARDEE ABOC, NCLE, LDO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HARDEE
Provider First Name:
DORIS
Provider Middle Name:
LORRAINE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
ABOC, NCLE, LDO
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HARDEE
Provider Other First Name:
MISSY
Provider Other Middle Name:
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1609592955
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/14/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2110 BELLS HWY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WALTERBORO
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29488-6978
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
843-539-1568
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2110 BELLS HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WALTERBORO
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29488-6978
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
843-539-1568
Provider Business Practice Location Address Fax Number:
843-539-1570
Provider Enumeration Date:
10/18/2022

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 156FX1800X , with the licence number:  723 , 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