Healthcare Provider Details

I. General information

NPI: 1679687651
Provider Name (Legal Business Name): CHARLESTON HEMATOLOGY AND ONCOLOGY PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2006
Last Update Date: 09/25/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 DOUGHTY ST STE 280
CHARLESTON SC
29403-5736
US

IV. Provider business mailing address

125 DOUGHTY ST STE 280
CHARLESTON SC
29403-5736
US

V. Phone/Fax

Practice location:
  • Phone: 843-577-6957
  • Fax: 843-577-2879
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number18925
License Number StateSC

VIII. Authorized Official

Name: JOHN ARRINGTON
Title or Position: CFO
Credential:
Phone: 843-266-2542