Healthcare Provider Details

I. General information

NPI: 1235675448
Provider Name (Legal Business Name): CHASTITY LEE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/11/2017
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2406 N MAIN ST STE A
ANDERSON SC
29621-3267
US

IV. Provider business mailing address

104 AMBERWOOD DR
ANDERSON SC
29621-3090
US

V. Phone/Fax

Practice location:
  • Phone: 864-276-1728
  • Fax:
Mailing address:
  • Phone: 864-276-1728
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: