Provider Demographics
NPI:1659664316
Name:SPEARS, CHARLES II
Entity Type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:
Last Name:SPEARS
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:623 GARDEN HILLS DR
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29505-3940
Mailing Address - Country:US
Mailing Address - Phone:843-496-2770
Mailing Address - Fax:
Practice Address - Street 1:623 GARDEN HILLS DR
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29505-3940
Practice Address - Country:US
Practice Address - Phone:843-496-2770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-26
Last Update Date:2011-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)