Healthcare Provider Details

I. General information

NPI: 1083120729
Provider Name (Legal Business Name): ARCIS HEALTHCARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2017
Last Update Date: 12/18/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

929 BOWMAN RD STE 400
MOUNT PLEASANT SC
29464-3237
US

IV. Provider business mailing address

93 SPRINGVIEW LN UNIT B
SUMMERVILLE SC
29485-8143
US

V. Phone/Fax

Practice location:
  • Phone: 843-730-4124
  • Fax: 843-806-4295
Mailing address:
  • Phone: 843-266-4883
  • Fax: 843-793-5444

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number StateSC
# 3
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number StateSC
# 4
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateSC
# 5
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number StateSC

VIII. Authorized Official

Name: DEBBE DAME DRIGGERS
Title or Position: CREDENTIALING SPECIALIST
Credential:
Phone: 843-266-4883