Provider Demographics
NPI:1407250756
Name:SOUTH CAROLINS SCHOOL FOR THE DEAF AND BLIND
Entity Type:Organization
Organization Name:SOUTH CAROLINS SCHOOL FOR THE DEAF AND BLIND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPY ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:SHERRIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCORD
Authorized Official - Suffix:
Authorized Official - Credentials:COTA
Authorized Official - Phone:803-295-7423
Mailing Address - Street 1:1120 WOMRATH RD
Mailing Address - Street 2:
Mailing Address - City:NORTH AUGUSTA
Mailing Address - State:SC
Mailing Address - Zip Code:29841-4401
Mailing Address - Country:US
Mailing Address - Phone:803-295-7423
Mailing Address - Fax:
Practice Address - Street 1:355 CEDAR SPRINGS RD
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29302-4628
Practice Address - Country:US
Practice Address - Phone:864-577-7782
Practice Address - Fax:864-577-7869
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-15
Last Update Date:2014-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCOTA2358251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCOTA3258OtherOCCUPATIONAL THERAPY ASSISTANT LICENSE NUMBER