Healthcare Provider Details

I. General information

NPI: 1518605435
Provider Name (Legal Business Name): MCHUGH MEDICAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2022
Last Update Date: 05/20/2022
Certification Date: 05/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

178 WREN ST
BARNWELL SC
29812-1527
US

IV. Provider business mailing address

634 PINE RIDGE DR STE B
WEST COLUMBIA SC
29172-1885
US

V. Phone/Fax

Practice location:
  • Phone: 803-259-1234
  • Fax: 803-259-5464
Mailing address:
  • Phone: 803-259-1234
  • Fax: 803-259-5464

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: KYLE MCHUGH
Title or Position: OWNER
Credential: PHARMACIST
Phone: 803-240-9882