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General NPI Number Information
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NPI Number | 1205280658
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Entity Type | Organization
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Legal Business Name | RSF MT PLEASANT HOSPITAL
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Dates
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Enumeration Date | 04/21/2016
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Last Update Date | 04/21/2016
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Provider Practice Location Address
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Address Line | 3500 N HIGHWAY 17
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City | MOUNT PLEASANT
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State | SC
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Zip | 29466-9123
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Country | US
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Telephone | 843-606-7565
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Fax | 843-606-7912
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Provider Business Mailing Address
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Address Line | PO BOX 602441
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City | CHARLOTTE
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State | NC
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Zip | 28260-2441
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Country | US
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Telephone | 843-606-7565
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Fax | 843-606-7912
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Authorized Official
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Title or Position | CEO
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Name | ANTHONY JACKSON
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Credential |
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Telephone | 843-606-1000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 42D2013764
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License Number State | SC
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