Provider Demographics
NPI:1619226842
Name:CAROLINA HORMONE AND HEALTH CENTER OF CHARLESTON
Entity Type:Organization
Organization Name:CAROLINA HORMONE AND HEALTH CENTER OF CHARLESTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHYRL
Authorized Official - Middle Name:
Authorized Official - Last Name:IVEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-606-2530
Mailing Address - Street 1:300 W COLEMAN BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-5604
Mailing Address - Country:US
Mailing Address - Phone:843-606-2530
Mailing Address - Fax:
Practice Address - Street 1:300 W COLEMAN BLVD STE 101
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-5604
Practice Address - Country:US
Practice Address - Phone:843-606-2530
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-04
Last Update Date:2012-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty