MEDICARE: SARAH HULL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1316316342
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH HULL

Provider Business Mailing Address
First Line	:	3489 OLD POND RD
Second Line	:
City	:	JOHNS ISLAND
State	:	SC
Zip	:	29455-3209
Country	:	US
Telephone Number	:	843-267-4248
Fax Number	:

Provider Business Practice Location Address
First Line	:	3 DANIEL ST
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29407-7303
Country	:	US
Telephone Number	:	843-225-2067
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/21/2015
Last Update Date	:	09/21/2015

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