Healthcare Provider Details

I. General information

NPI: 1891007332
Provider Name (Legal Business Name): CAVES MEDICAL & REHABILITATION CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2010
Last Update Date: 07/13/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2757 LAUREL ST STE 4A
COLUMBIA SC
29204-2037
US

IV. Provider business mailing address

2757 LAUREL ST STE 4
COLUMBIA SC
29204-2037
US

V. Phone/Fax

Practice location:
  • Phone: 803-252-4966
  • Fax:
Mailing address:
  • Phone: 803-252-4966
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State

VIII. Authorized Official

Name: MISS VIRGINIA K SAMUEL
Title or Position: PRESIDENT
Credential: DC
Phone: 803-252-4966