Healthcare Provider Details

I. General information

NPI: 1447194881
Provider Name (Legal Business Name): CHICO JOHNSON
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/16/2026
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1937 HIGHWAY 9 W
DILLON SC
29536-7838
US

IV. Provider business mailing address

1937 HIGHWAY 9 W
DILLON SC
29536-7838
US

V. Phone/Fax

Practice location:
  • Phone: 843-627-1397
  • Fax:
Mailing address:
  • Phone: 843-627-1397
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code342000000X
TaxonomyTransportation Network Company
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: