Provider Demographics
NPI:1184811341
Name:KHACHATRIAN, ANAHIT
Entity type:Individual
Prefix:
First Name:ANAHIT
Middle Name:
Last Name:KHACHATRIAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1904 ACADEMY ST UNIT C
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29203-6958
Mailing Address - Country:US
Mailing Address - Phone:803-665-1301
Mailing Address - Fax:803-407-0534
Practice Address - Street 1:1904 ACADEMY ST UNIT C
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203-6958
Practice Address - Country:US
Practice Address - Phone:803-665-1301
Practice Address - Fax:803-407-0534
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-01
Last Update Date:2008-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies