Healthcare Provider Details

I. General information

NPI: 1184425597
Provider Name (Legal Business Name): MELISSA SLICE MCCAWLEY RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2025
Last Update Date: 03/21/2025
Certification Date: 03/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6439 GARNERS FERRY RD
COLUMBIA SC
29209-1638
US

IV. Provider business mailing address

311 LEXINGTON AVE
CHAPIN SC
29036-8093
US

V. Phone/Fax

Practice location:
  • Phone: 803-776-4000
  • Fax: 803-695-8135
Mailing address:
  • Phone: 803-422-0259
  • Fax: 803-695-8135

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WX0200X
TaxonomyOncology Registered Nurse
License Number2160102
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: