MEDICARE: AHP ASSOCIATES OF SOUTH CAROLINA LLC

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
1	367500000X	Certified Registered Nurse Anesthetist

Other Identifiers

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

General Provider Information

NPI Number	:	1245288281
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AHP ASSOCIATES OF SOUTH CAROLINA LLC

Provider Business Mailing Address
First Line	:	DEPT 40101 PO BOX 740209
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30374-0209
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1735 TAYLOR ST
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29201-3452
Country	:	US
Telephone Number	:	803-254-8449
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	SEAN LYNCH
Credential	:
Telephone Number	:	770-945-5330

Provider Enumeration Date	:	05/04/2006
Last Update Date	:	07/16/2007

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