Healthcare Provider Details

I. General information

NPI: 1558587113
Provider Name (Legal Business Name): SOUTH CAROLINA WOMEN'S CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2007
Last Update Date: 10/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1312 ASHLEY RIVER RD
CHARLESTON SC
29407-5365
US

IV. Provider business mailing address

1312 ASHLEY RIVER RD
CHARLESTON SC
29407-5365
US

V. Phone/Fax

Practice location:
  • Phone: 843-571-5161
  • Fax: 843-571-6650
Mailing address:
  • Phone:
  • Fax: 843-571-6650

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0005X
TaxonomyAmbulatory Family Planning Facility
License Number2783
License Number StateSC

VIII. Authorized Official

Name: SHIRLEY DUNCAN
Title or Position: OFFICE MANAGER
Credential:
Phone: 843-571-5161