Provider Demographics
NPI:1225017205
Name:CAROLINA PULMONARY & CRITICAL CARE
Entity Type:Organization
Organization Name:CAROLINA PULMONARY & CRITICAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:J
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:LOVE
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:803-256-0464
Mailing Address - Street 1:1333 TAYLOR ST
Mailing Address - Street 2:STE 6F
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29201-0127
Mailing Address - Country:US
Mailing Address - Phone:803-256-0464
Mailing Address - Fax:803-254-5121
Practice Address - Street 1:1333 TAYLOR ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-2953
Practice Address - Country:US
Practice Address - Phone:803-256-0464
Practice Address - Fax:803-254-5121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-10
Last Update Date:2007-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC7594207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC1427036375OtherNPI
SC5253Medicare PIN