Provider Demographics
NPI:1497731889
Name:CHAPCO MANAGEMENT INC
Entity Type:Organization
Organization Name:CHAPCO MANAGEMENT INC
Other - Org Name:A COMFORT SHOE & PEDORTHIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:FEREL
Authorized Official - Last Name:CHAPMAN
Authorized Official - Suffix:JR
Authorized Official - Credentials:PEDORTHIST
Authorized Official - Phone:843-272-8080
Mailing Address - Street 1:1238 HIGHWAY 17 S
Mailing Address - Street 2:
Mailing Address - City:NORTH MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29582-3707
Mailing Address - Country:US
Mailing Address - Phone:843-272-8080
Mailing Address - Fax:843-361-8442
Practice Address - Street 1:1238 HIGHWAY 17 S
Practice Address - Street 2:
Practice Address - City:NORTH MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29582-3707
Practice Address - Country:US
Practice Address - Phone:843-272-8080
Practice Address - Fax:843-361-8442
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCDE1469Medicaid
SCDE1469Medicaid