Healthcare Provider Details

I. General information

NPI: 1023231479
Provider Name (Legal Business Name): MUSC HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

96 JONATHAN LUCAS ST SUITE 409
CHARLESTON SC
29425-8900
US

IV. Provider business mailing address

96 JONATHAN LUCAS ST SUITE 409
CHARLESTON SC
29425-8900
US

V. Phone/Fax

Practice location:
  • Phone: 843-792-5897
  • Fax: 843-792-8286
Mailing address:
  • Phone: 843-792-5897
  • Fax: 843-792-8286

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number State

VIII. Authorized Official

Name: MRS. GLADNEY POWERS BROOKS
Title or Position: NP
Credential:
Phone: 843-792-5897