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General NPI Number Information
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NPI Number | 1003915877
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Entity Type | Organization
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Legal Business Name | EAST AIKEN HEALTH CENTER L.L.C.
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Dates
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Enumeration Date | 09/21/2006
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Last Update Date | 01/08/2008
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Provider Practice Location Address
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Address Line | 1847 HATCHAWAY BRIDGE RD EAST AIKEN HEALTH CENTER
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City | AIKEN
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State | SC
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Zip | 29805-8163
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Country | US
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Telephone | 803-644-7033
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Fax | 803-644-8250
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Provider Business Mailing Address
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Address Line | 1847 HATCHAWAY BRIDGE RD EAST AIKEN HEALTH CENTER
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City | AIKEN
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State | SC
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Zip | 29805-8163
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Country | US
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Telephone | 803-644-7033
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Fax | 803-644-8250
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | BERNARD JOHN KULE
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Credential | MD
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Telephone | 803-644-7033
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 17237
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License Number State | SC
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