Provider Demographics
NPI:1841414562
Name:BETHEA, ARLINE
Entity type:Individual
Prefix:
First Name:ARLINE
Middle Name:
Last Name:BETHEA
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 1:1006 PASTURE LN
Mailing Address - Street 2:
Mailing Address - City:ORANGEBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29118-9307
Mailing Address - Country:US
Mailing Address - Phone:803-533-6098
Mailing Address - Fax:803-533-0375
Practice Address - Street 1:1006 PASTURE LN
Practice Address - Street 2:
Practice Address - City:ORANGEBURG
Practice Address - State:SC
Practice Address - Zip Code:29118-9307
Practice Address - Country:US
Practice Address - Phone:803-533-6098
Practice Address - Fax:803-533-0375
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health