Healthcare Provider Details

I. General information

NPI: 1922752989
Provider Name (Legal Business Name): BRITANY NICOLE THOMPSON HAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/09/2022
Last Update Date: 02/05/2024
Certification Date: 02/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 RICHLAND MEDICAL PARK DR STE 130
COLUMBIA SC
29203-6850
US

IV. Provider business mailing address

3 RICHLAND MEDICAL PARK DR STE 130
COLUMBIA SC
29203-6850
US

V. Phone/Fax

Practice location:
  • Phone: 803-765-1919
  • Fax: 803-849-8875
Mailing address:
  • Phone: 803-765-1919
  • Fax: 803-849-8875

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number0713
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: