Healthcare Provider Details

I. General information

NPI: 1881912707
Provider Name (Legal Business Name): CAROLINA HYPERBARIC AND CONSULTATION SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2010
Last Update Date: 03/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 S HERLONG AVE
ROCK HILL SC
29732-1158
US

IV. Provider business mailing address

PO BOX 2974
ROCK HILL SC
29732-4974
US

V. Phone/Fax

Practice location:
  • Phone: 803-329-6711
  • Fax: 803-329-5120
Mailing address:
  • Phone: 803-985-4551
  • Fax: 803-985-4543

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PE0005X
TaxonomyUndersea and Hyperbaric Medicine (Emergency Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: RICHARD L. RICHTER
Title or Position: ANESTHESIOLOGIST
Credential: M.D.
Phone: 803-329-6711