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General NPI Number Information
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NPI Number | 1366631046
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Entity Type | Organization
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Legal Business Name | CHARLESTON HYPERBARIC MEDICINE INC.
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Dates
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Enumeration Date | 10/18/2007
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 9231 MEDICAL PLAZA DR SUITE C
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City | NORTH CHARLESTON
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State | SC
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Zip | 29406-9101
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Country | US
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Telephone | 843-572-8050
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Fax | 843-569-2281
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Provider Business Mailing Address
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Address Line | PO BOX 146
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City | LADSON
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State | SC
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Zip | 29456-0146
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Country | US
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Telephone | 843-572-8050
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Fax | 843-569-2281
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. ELAINE DEVLIN PEERY
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Credential | LPN II
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Telephone | 843-572-8050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State | SC
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