Provider Demographics
NPI:1689755464
Name:CMI - FLORENCE
Entity Type:Organization
Organization Name:CMI - FLORENCE
Other - Org Name:CARTER CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:843-665-7500
Mailing Address - Street 1:PO BOX 5477
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29502-5477
Mailing Address - Country:US
Mailing Address - Phone:843-665-7500
Mailing Address - Fax:843-665-7530
Practice Address - Street 1:3124 S CASHUA DR
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29501-6302
Practice Address - Country:US
Practice Address - Phone:843-665-7500
Practice Address - Fax:843-665-7530
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2009-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC0281Medicare UPIN