Provider Demographics
NPI:1689972739
Name:NASON MEDICAL CENTER IV, LLC
Entity Type:Organization
Organization Name:NASON MEDICAL CENTER IV, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BARRON
Authorized Official - Middle Name:S
Authorized Official - Last Name:NASON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:843-552-4240
Mailing Address - Street 1:PO BOX 51629
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29485-1629
Mailing Address - Country:US
Mailing Address - Phone:843-300-3500
Mailing Address - Fax:843-552-4121
Practice Address - Street 1:319 FOLLY RD
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29412-2518
Practice Address - Country:US
Practice Address - Phone:843-300-3500
Practice Address - Fax:843-552-4121
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NASON MEDICAL CENTER, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-03-14
Last Update Date:2012-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care