Provider Demographics
NPI:1013382290
Name:CJS MEDICAL SERVICES, PC
Entity Type:Organization
Organization Name:CJS MEDICAL SERVICES, PC
Other - Org Name:NUCOR BERKELEY FAMILY MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:SANDERS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:803-926-0213
Mailing Address - Street 1:723 BAKER MILL LAKE LN
Mailing Address - Street 2:
Mailing Address - City:GASTON
Mailing Address - State:SC
Mailing Address - Zip Code:29053-8327
Mailing Address - Country:US
Mailing Address - Phone:803-926-0213
Mailing Address - Fax:
Practice Address - Street 1:1455 HAGAN AVENUE
Practice Address - Street 2:
Practice Address - City:HUGER
Practice Address - State:SC
Practice Address - Zip Code:29450
Practice Address - Country:US
Practice Address - Phone:843-336-6436
Practice Address - Fax:843-336-6836
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CJS MEDICAL SERVICES, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-12-14
Last Update Date:2015-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC17688261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center