Provider Demographics
NPI:1255545406
Name:PEE DEE HEARING CENTER
Entity type:Organization
Organization Name:PEE DEE HEARING CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BILLING/CREDENTIALING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:ADRIENNE
Authorized Official - Middle Name:
Authorized Official - Last Name:HUGGINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-662-7802
Mailing Address - Street 1:PO BOX 804
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29503-0804
Mailing Address - Country:US
Mailing Address - Phone:843-662-7802
Mailing Address - Fax:843-662-5601
Practice Address - Street 1:153 E N B BAROODY ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29506-2523
Practice Address - Country:US
Practice Address - Phone:843-662-7802
Practice Address - Fax:843-662-5601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-09
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC284802Medicaid
OK1487957304OtherBCBS, HUMANA, UNITED, CIGNA, AETNA, TRICARE,
OK1487957304Medicaid