Provider Demographics
NPI:1295226173
Name:HILL, KASHASTA
Entity Type:Individual
Prefix:
First Name:KASHASTA
Middle Name:
Last Name:HILL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:528 EDGEFIELD RD STE B2
Mailing Address - Street 2:
Mailing Address - City:NORTH AUGUSTA
Mailing Address - State:SC
Mailing Address - Zip Code:29841-1916
Mailing Address - Country:US
Mailing Address - Phone:803-510-4946
Mailing Address - Fax:803-510-4946
Practice Address - Street 1:528 EDGEFIELD RD
Practice Address - Street 2:
Practice Address - City:NORTH AUGUSTA
Practice Address - State:SC
Practice Address - Zip Code:29841-1922
Practice Address - Country:US
Practice Address - Phone:803-510-4946
Practice Address - Fax:803-510-4946
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-25
Last Update Date:2018-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health