Healthcare Provider Details
I. General information
NPI: 1932294766
Provider Name (Legal Business Name): NATIONAL ALLERGY ASTHMA & URTICARIA CENTERS OF CHARLESTON PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/04/2006
Last Update Date: 06/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7555 NORTHSIDE DR
CHARLESTON SC
29420-4211
US
IV. Provider business mailing address
730 STONY LANDING RD SUITE 200
MONCKS CORNER SC
29461-2904
US
V. Phone/Fax
- Phone: 843-797-8162
- Fax: 843-797-8372
- Phone: 843-797-8162
- Fax: 843-797-8372
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207KA0200X |
| Taxonomy | Allergy Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MRS.
AMBER
MURPHY
Title or Position: DIRECTOR
Credential:
Phone: 843-820-1302