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General NPI Number Information
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NPI Number | 1306181300
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Entity Type | Organization
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Legal Business Name | VA HOSPITAL
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Dates
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Enumeration Date | 12/01/2012
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Last Update Date | 12/01/2012
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Provider Practice Location Address
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Address Line | 138 FREMONT DR
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City | SUMMERVILLE
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State | SC
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Zip | 29483-7759
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Country | US
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Telephone | 843-906-8203
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Fax |
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Provider Business Mailing Address
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Address Line | 138 FREMONT DR
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City | SUMMERVILLE
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State | SC
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Zip | 29483-7759
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Country | US
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Telephone | 843-906-8203
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Fax |
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Authorized Official
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Title or Position | REGISTERED RESPIRATORY THERAPIST
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Name | HOLLY T WILLIAMS
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Credential |
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Telephone | 843-906-8203
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2865M2000X
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Taxonomy Name | Military General Acute Care Hospital
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License Number | 116499
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License Number State | SC
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