Provider Demographics
NPI:1770848202
Name:CASPERS
Entity Type:Organization
Organization Name:CASPERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:TANYA
Authorized Official - Middle Name:W
Authorized Official - Last Name:MULLINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-687-6843
Mailing Address - Street 1:PO BOX 662
Mailing Address - Street 2:
Mailing Address - City:KINGSTREE
Mailing Address - State:SC
Mailing Address - Zip Code:29556-0662
Mailing Address - Country:US
Mailing Address - Phone:843-687-6843
Mailing Address - Fax:843-407-7297
Practice Address - Street 1:107 E MILL ST
Practice Address - Street 2:
Practice Address - City:KINGSTREE
Practice Address - State:SC
Practice Address - Zip Code:29556-3427
Practice Address - Country:US
Practice Address - Phone:843-687-6843
Practice Address - Fax:843-407-7297
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-11
Last Update Date:2012-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies