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General NPI Number Information
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NPI Number | 1740420710
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Entity Type | Organization
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Legal Business Name | CHARLESTON NEUROSCIENCE INSTITUTE LLC
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Dates
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Enumeration Date | 03/03/2009
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Last Update Date | 03/03/2009
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Provider Practice Location Address
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Address Line | 9551 HWY 78 BLDG 700 SUITE 101
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City | LADSON
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State | SC
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Zip | 29406
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Country | US
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Telephone | 843-572-0662
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Fax | 843-572-0663
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Provider Business Mailing Address
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Address Line | 9551 HWY 78 BLDG 700 SUITE 101
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City | LADSON
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State | SC
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Zip | 29406
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Country | US
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Telephone | 843-572-0662
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Fax | 843-572-0663
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Authorized Official
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Title or Position | PARTNER
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Name | ERIC JABLON
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Credential | MD
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Telephone | 843-572-0062
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number |
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License Number State |
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