Healthcare Provider Details

I. General information

NPI: 1881786747
Provider Name (Legal Business Name): ROMICO DIONE CAUGHMAN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

61 1/2 SAMSON CIR
COLUMBIA SC
29203-4945
US

IV. Provider business mailing address

61 1/2 SAMSON CIR
COLUMBIA SC
29203-4945
US

V. Phone/Fax

Practice location:
  • Phone: 803-786-0940
  • Fax:
Mailing address:
  • Phone: 803-786-0940
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number70050
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: