Provider Demographics
NPI:1366631046
Name:CHARLESTON HYPERBARIC MEDICINE INC.
Entity Type:Organization
Organization Name:CHARLESTON HYPERBARIC MEDICINE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:ELAINE
Authorized Official - Middle Name:DEVLIN
Authorized Official - Last Name:PEERY
Authorized Official - Suffix:
Authorized Official - Credentials:LPN II
Authorized Official - Phone:843-572-8050
Mailing Address - Street 1:PO BOX 146
Mailing Address - Street 2:
Mailing Address - City:LADSON
Mailing Address - State:SC
Mailing Address - Zip Code:29456-0146
Mailing Address - Country:US
Mailing Address - Phone:843-572-8050
Mailing Address - Fax:843-569-2281
Practice Address - Street 1:9231 MEDICAL PLAZA DR
Practice Address - Street 2:SUITE C
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29406-9101
Practice Address - Country:US
Practice Address - Phone:843-572-8050
Practice Address - Fax:843-569-2281
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty