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COASTAL VASCULAR & VEIN CENTER PA NPI 1548936909


NPI Information

NPI: 1548936909
Provider Name: COASTAL VASCULAR & VEIN CENTER PA
Classification: Prosthetic/Orthotic Supplier - 335E00000X
Entity Type: Organization

CLIA Number: 42D2090083

Address:
2575 ELMS CENTER RD STE 200
N CHARLESTON, SC
ZIP 29406
Phone: (843) 577-4551
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COASTAL VASCULAR & VEIN CENTER PA is a prosthetic orthotic supplier in N Charleston, SC. The provider is an organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition. COASTAL VASCULAR & VEIN CENTER PA NPI is 1548936909. The provider is registered as an organization entity type.

The provider's business location address is:

2575 ELMS CENTER RD STE 200
N CHARLESTON, SC
ZIP 29406-875
Phone: (843) 577-4551
Fax: (843) 577-2227

The provider's authorized official is Evelyn Carter .
The authorized official title is Chief Administrative Officer and has the following contact phone number (843) 300-3583.

The CLIA number assigned to this NPI record is 42D2090083 - other - outpt clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/17/2021 and was last updated on 8/17/2021.


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
1335E00000XProsthetic/Orthotic SupplierYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1DE3876MEDICAIDSOUTH CAROLINA

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: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.