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General NPI Number Information
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NPI Number | 1629576848
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Entity Type | Organization
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Legal Business Name | CAROLINA INTERVENTIONAL PAIN INSTITUTE, LLC
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Dates
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Enumeration Date | 01/23/2018
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Last Update Date | 10/08/2024
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Provider Practice Location Address
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Address Line | 2611 FOREST DR STE 100
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City | COLUMBIA
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State | SC
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Zip | 29204-2371
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Country | US
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Telephone | 803-779-3263
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Fax |
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Provider Business Mailing Address
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Address Line | 2611 FOREST DR STE 200
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City | COLUMBIA
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State | SC
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Zip | 29204-2371
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Country | US
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Telephone | 803-779-3263
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Fax |
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Authorized Official
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Title or Position | BILLING ADMIN
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Name | CHRISTINA B SMOAK
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Credential |
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Telephone | 803-779-3263
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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