Healthcare Provider Details

I. General information

NPI: 1659101277
Provider Name (Legal Business Name): MEDICAL UNIVERSITY HOSPITAL AUTHORITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2024
Last Update Date: 02/07/2025
Certification Date: 02/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 MCCLENNAN BANKS
CHARLESTON SC
29425-1164
US

IV. Provider business mailing address

PO BOX 23319
NEW YORK NY
10087-3319
US

V. Phone/Fax

Practice location:
  • Phone: 843-792-1414
  • Fax:
Mailing address:
  • Phone: 843-792-1414
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283XC2000X
TaxonomyChildren's Rehabilitation Hospital
License Number
License Number State

VIII. Authorized Official

Name: KARYN RAE
Title or Position: CHIEF, PAYOR RELATIONS
Credential:
Phone: 843-876-1344