CHARLESTON VAMC NPI 1164810297

NPI Information

NPI: 1164810297
Provider Name: CHARLESTON VAMC

Other Name: MYRTLE BEACH 1 VA CLINIC

Classification: Clinic/Center - 261QV0200X
Entity Type: Organization

Specialization: VA

CLIA Number: 42D2038789

Address:
1101 JOHNSON AVE
SUITE R-2A
MYRTLE BEACH, SC
ZIP 29577
Phone: (828) 257-2333
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CHARLESTON VAMC is a va clinic center in Myrtle Beach, SC. CHARLESTON VAMC NPI is 1164810297. The provider is registered as an organization entity type.
The provider Other Name Is Myrtle Beach 1 Va Clinic.

The provider's business location address is:

1101 JOHNSON AVE
SUITE R-2A
MYRTLE BEACH, SC
ZIP 29577-893
Phone: (828) 257-2333

The provider's authorized official is Erin Potter .
The authorized official title is Npi Team Member and has the following contact phone number (202) 382-2579.

The CLIA number assigned to this NPI record is 42D2038789 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 12/23/2014 and was last updated on 4/13/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QV0200X	Clinic/Center	VA			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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