Provider Demographics
NPI:1982961793
Name:CARING HEARTS PEDIATRICS
Entity Type:Organization
Organization Name:CARING HEARTS PEDIATRICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:ALDERMAN
Authorized Official - Last Name:COWARD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:843-332-9625
Mailing Address - Street 1:518 E CAROLINA AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:HARTSVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29550-4312
Mailing Address - Country:US
Mailing Address - Phone:843-332-9625
Mailing Address - Fax:843-383-8509
Practice Address - Street 1:518 E CAROLINA AVE
Practice Address - Street 2:SUITE B
Practice Address - City:HARTSVILLE
Practice Address - State:SC
Practice Address - Zip Code:29550-4312
Practice Address - Country:US
Practice Address - Phone:843-332-9625
Practice Address - Fax:843-383-8509
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-18
Last Update Date:2012-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5686174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC056860Medicaid