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General NPI Number Information
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NPI Number | 1295161420
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Entity Type | Organization
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Legal Business Name | MEDICAL UNIVERSITY OF SOUTH CAROLINA
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Dates
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Enumeration Date | 09/19/2013
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Last Update Date | 09/19/2013
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Provider Practice Location Address
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Address Line | 8792 SHADOWGLEN DR
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City | NORTH CHARLESTON
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State | SC
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Zip | 29420-8358
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Country | US
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Telephone | 843-793-7893
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Fax |
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Provider Business Mailing Address
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Address Line | 8792 SHADOWGLEN DR
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City | NORTH CHARLESTON
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State | SC
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Zip | 29420-8358
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | RN
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Name | MR. BRANDON WILLIAMS
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Credential | RN BSN
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Telephone | 843-793-7893
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NC0060X
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Taxonomy Name | Critical Access Hospital
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License Number | 213069
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License Number State | SC
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