Healthcare Provider Details

I. General information

NPI: 1295797314
Provider Name (Legal Business Name): HITCHCOCK HEALTHCARE, INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2006
Last Update Date: 07/10/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

690 MEDICAL PARK DR
AIKEN SC
29801-6348
US

IV. Provider business mailing address

690 MEDICAL PARK DR
AIKEN SC
29801-6348
US

V. Phone/Fax

Practice location:
  • Phone: 803-648-8344
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: KAREN BOWLES
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 803-293-4342