Provider Demographics
NPI:1437529260
Name:HOPE CLINIC
Entity Type:Organization
Organization Name:HOPE CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:TEMISAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ETIKERENTSE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:843-725-4673
Mailing Address - Street 1:5880 RIVERS AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29406-6053
Mailing Address - Country:US
Mailing Address - Phone:843-725-4673
Mailing Address - Fax:843-725-1235
Practice Address - Street 1:5880 RIVERS AVE
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29406-6053
Practice Address - Country:US
Practice Address - Phone:843-725-4673
Practice Address - Fax:843-725-1235
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-06
Last Update Date:2015-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC24720000X261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care