Healthcare Provider Details

I. General information

NPI: 1053744060
Provider Name (Legal Business Name): CROSSING PATHS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2013
Last Update Date: 08/13/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6277 CAROLINA COMMONS DR STE 200
INDIAN LAND SC
29707-6003
US

IV. Provider business mailing address

517 ALCOVE RD STE 201
MOORESVILLE NC
28117-8574
US

V. Phone/Fax

Practice location:
  • Phone: 803-396-0504
  • Fax: 803-396-0514
Mailing address:
  • Phone: 704-660-8282
  • Fax: 704-660-8285

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License NumberHAS-0518
License Number StateSC

VIII. Authorized Official

Name: MR. BRAD JONES
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 704-660-8282