Provider Demographics
NPI:1013226745
Name:JCRK MANAGEMENT INC
Entity Type:Organization
Organization Name:JCRK MANAGEMENT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:E
Authorized Official - Last Name:CRAIGIE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:843-388-0660
Mailing Address - Street 1:1300 HOSPITAL DR
Mailing Address - Street 2:STE 120
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-3261
Mailing Address - Country:US
Mailing Address - Phone:843-388-0660
Mailing Address - Fax:843-849-8419
Practice Address - Street 1:1300 HOSPITAL DR
Practice Address - Street 2:STE 120
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-3261
Practice Address - Country:US
Practice Address - Phone:843-388-0660
Practice Address - Fax:843-849-8419
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-29
Last Update Date:2010-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical