Healthcare Provider Details

I. General information

NPI: 1245661586
Provider Name (Legal Business Name): EAST COOPER HYPERBARICS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2013
Last Update Date: 05/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1156 BOWMAN RD STE 103
MT PLEASANT SC
29464-3803
US

IV. Provider business mailing address

1156 BOWMAN RD STE 103
MT PLEASANT SC
29464-3803
US

V. Phone/Fax

Practice location:
  • Phone: 843-856-1771
  • Fax: 843-856-8788
Mailing address:
  • Phone: 843-856-1771
  • Fax: 843-856-8788

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207PE0005X
TaxonomyUndersea and Hyperbaric Medicine (Emergency Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. WESLEY O. JAMES
Title or Position: REGIONAL CFO, TENET
Credential:
Phone: 404-265-5009