Healthcare Provider Details

I. General information

NPI: 1427809664
Provider Name (Legal Business Name): LOWCOUNTRY ONCOLOGY ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2024
Last Update Date: 11/06/2024
Certification Date: 11/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9313 MEDICAL PLAZA DR STE 103
NORTH CHARLESTON SC
29406-9802
US

IV. Provider business mailing address

9313 MEDICAL PLAZA DR STE 103
N CHARLESTON SC
29406-9802
US

V. Phone/Fax

Practice location:
  • Phone: 843-790-8280
  • Fax: 843-974-8500
Mailing address:
  • Phone: 843-790-8280
  • Fax: 843-974-8500

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0000X
TaxonomyHematology (Internal Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. LIA HOOD
Title or Position: SR. MANGER, CREDENTIALING
Credential:
Phone: 843-790-8280