Healthcare Provider Details

I. General information

NPI: 1326155003
Provider Name (Legal Business Name): CAROLINA EAR CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2006
Last Update Date: 07/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 PROFESSIONAL AVE
WEST COLUMBIA SC
29169-4711
US

IV. Provider business mailing address

103 PROFESSIONAL AVE
WEST COLUMBIA SC
29169-4711
US

V. Phone/Fax

Practice location:
  • Phone: 803-926-2220
  • Fax: 803-926-2220
Mailing address:
  • Phone: 803-926-2220
  • Fax: 803-926-2220

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231HA2400X
TaxonomyAssistive Technology Practitioner Audiologist
License Number2932
License Number StateSC

VIII. Authorized Official

Name: DR. CHAD FOX
Title or Position: OWNER/AUDIOLOGIST
Credential: AU.D.
Phone: 803-926-2220