Provider Demographics
NPI:1437387701
Name:HAMRICK, MEAH S (OTD)
Entity Type:Individual
Prefix:
First Name:MEAH
Middle Name:S
Last Name:HAMRICK
Suffix:
Gender:F
Credentials:OTD
Other - Prefix:
Other - First Name:MEAH
Other - Middle Name:D
Other - Last Name:STATEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:28 TINDAL AVE
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29605-3973
Mailing Address - Country:US
Mailing Address - Phone:864-905-4040
Mailing Address - Fax:
Practice Address - Street 1:1011 FRONTAGE RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-4240
Practice Address - Country:US
Practice Address - Phone:864-242-4263
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-25
Last Update Date:2019-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3790225X00000X
AZ4384225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ441047Medicaid
AZZ131163Medicare PIN
SCQ454324272Medicare PIN
SC0212480001Medicare NSC