Healthcare Provider Details

I. General information

NPI: 1316190143
Provider Name (Legal Business Name): JAMES ISLAND CHARTER HIGH SCHOOL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2008
Last Update Date: 10/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 FORT JOHNSON ROAD
CHARLESTON SC
29412
US

IV. Provider business mailing address

1000 FORT JOHNSON ROAD
CHARLESTON SC
29412
US

V. Phone/Fax

Practice location:
  • Phone: 843-762-2754
  • Fax: 843-762-5228
Mailing address:
  • Phone: 843-762-2754
  • Fax: 843-762-5228

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number State

VIII. Authorized Official

Name: ROBERT E. BOHNSTENGEL
Title or Position: PRINCIPAL JAMES ISLAND CHARTER HIGH
Credential:
Phone: 843-762-5200