Provider Demographics
NPI:1649692252
Name:GOOD HOPE MEDICAL ASSOCIATES
Entity type:Organization
Organization Name:GOOD HOPE MEDICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:A
Authorized Official - Last Name:CHAMBERS
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:814-229-0414
Mailing Address - Street 1:180 GOOD HOPE RD
Mailing Address - Street 2:
Mailing Address - City:BLUFFTON
Mailing Address - State:SC
Mailing Address - Zip Code:29909-3104
Mailing Address - Country:US
Mailing Address - Phone:814-229-0414
Mailing Address - Fax:843-706-3350
Practice Address - Street 1:180 GOOD HOPE RD
Practice Address - Street 2:
Practice Address - City:BLUFFTON
Practice Address - State:SC
Practice Address - Zip Code:29909-3104
Practice Address - Country:US
Practice Address - Phone:814-229-0414
Practice Address - Fax:843-706-3350
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-16
Last Update Date:2014-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCMD34703261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care