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NPI Code Detail

MEDICARE: SOUTH CAROLINA HEART CENTER PA

MEDICARE: SOUTH CAROLINA HEART CENTER PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RC0000XCardiovascular Disease PhysicianSC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1184886798
Entity Type Code : Organization
Provider Name (Legal Business Name) : SOUTH CAROLINA HEART CENTER PA
Provider Business Mailing Address
First Line : PO BOX 99
Second Line :
City : COLUMBIA
State : SC
Zip : 29202-0099
Country : US
Telephone Number : 803-254-3278
Fax Number : 803-376-8010
Provider Business Practice Location Address
First Line : 1330 HAILE ST
Second Line :
City : CAMDEN
State : SC
Zip : 29020-3002
Country : US
Telephone Number : 803-432-6771
Fax Number : 803-424-1900
Authorized Official
Title or Position : CHIEF FINANCIAL OFFICER
Name : KATHY KOENIG
Credential :
Telephone Number : 803-254-3278
Provider Enumeration Date : 06/26/2008
Last Update Date : 06/26/2008

Similar Medicare Providers

1942204912 — MITCHELL TODD ALDERSON M.D.
Practice Location Address:
1330 HAILE ST
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1568496271 — DR. ROBERT G KIGER MD
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1629002332 — PAUL A ZIMMERMANN MD
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1710996129 — SHELLY C WILKERSON NP
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1760763312 — PROVIDENCE CARDIOLOGY LLC
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1336599299 — DR. TARUN BHANDARI MD
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Directions to “SOUTH CAROLINA HEART CENTER PA ” Practice Location

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