Provider Demographics
NPI:1497078125
Name:CHARLESTON NEUROSCIENCE INSTITUTE
Entity type:Organization
Organization Name:CHARLESTON NEUROSCIENCE INSTITUTE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:P
Authorized Official - Last Name:JABLON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:843-216-7144
Mailing Address - Street 1:590 LONE TREE DR
Mailing Address - Street 2:STE. 102
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-8170
Mailing Address - Country:US
Mailing Address - Phone:843-375-2363
Mailing Address - Fax:843-628-4862
Practice Address - Street 1:590 LONE TREE DR
Practice Address - Street 2:STE. 102
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-8170
Practice Address - Country:US
Practice Address - Phone:843-375-2363
Practice Address - Fax:843-628-4862
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHARLESTON NEUROSCIENCE INSTITUTE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-03-09
Last Update Date:2010-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies