Provider Demographics
NPI:1639234206
Name:OPTION CARE OF THE LOWCOUNTRY
Entity Type:Organization
Organization Name:OPTION CARE OF THE LOWCOUNTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:BURKE
Authorized Official - Suffix:
Authorized Official - Credentials:R PH
Authorized Official - Phone:843-689-9698
Mailing Address - Street 1:1 MATHEWS DR
Mailing Address - Street 2:SUITE #107
Mailing Address - City:HILTON HEAD ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29926-3746
Mailing Address - Country:US
Mailing Address - Phone:843-689-9698
Mailing Address - Fax:
Practice Address - Street 1:1 MATHEWS DR
Practice Address - Street 2:SUITE #107
Practice Address - City:HILTON HEAD ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29926-3746
Practice Address - Country:US
Practice Address - Phone:843-689-9698
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC500035473336H0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC1128180001Medicare UPIN