Provider Demographics
NPI:1851445134
Name:KATIE CUTIE INC.
Entity Type:Organization
Organization Name:KATIE CUTIE INC.
Other - Org Name:LOWCOUNTRY REHAB
Other - Org Type:Other Name
Authorized Official - Title/Position:HIPPA REP
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:W
Authorized Official - Last Name:YORK
Authorized Official - Suffix:III
Authorized Official - Credentials:NCACII
Authorized Official - Phone:843-607-0215
Mailing Address - Street 1:103 3RD ST E
Mailing Address - Street 2:PO BOX 574
Mailing Address - City:HAMPTON
Mailing Address - State:SC
Mailing Address - Zip Code:29924-2511
Mailing Address - Country:US
Mailing Address - Phone:843-607-0215
Mailing Address - Fax:843-538-7326
Practice Address - Street 1:103 3RD ST E
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:SC
Practice Address - Zip Code:29924-2511
Practice Address - Country:US
Practice Address - Phone:803-943-3914
Practice Address - Fax:843-538-7326
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2009-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP2069Medicaid
SC426607Medicare PIN