Healthcare Provider Details

I. General information

NPI: 1033291513
Provider Name (Legal Business Name): SOUTH CAROLINA ONCOLOGY ASSOCIATES PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/20/2006
Last Update Date: 06/30/2023
Certification Date: 06/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

166 STONERIDGE DR
COLUMBIA SC
29210-8239
US

IV. Provider business mailing address

166 STONERIDGE DR
COLUMBIA SC
29210-8239
US

V. Phone/Fax

Practice location:
  • Phone: 803-461-3709
  • Fax: 803-461-3426
Mailing address:
  • Phone: 803-461-3709
  • Fax: 803-461-3426

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number7987
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DR. ERIC SOONG
Title or Position: DIRECTOR OF PHARMACY
Credential: PHARMD
Phone: 803-461-3077