Coastal Podiatry Llc

LBN: Coastal Podiatry Llc
Coastal Podiatry Llc is an health care organization with primary practice located at 180 Wingo Way Suite 201, Mount Pleasant SC 29464-1810. The organization recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as the primary health care specialty. Coastal Podiatry Llc can be contacted via phone (843) 856-5337, or through Bolden Ravenell, Tamika Michelle via phone (916) 215-1234.

Contact Information

Primary practice address
180 Wingo Way Suite 201 Mount Pleasant SC 29464-1810
Phone: (843) 856-5337
Fax: (843) 606-2483
Website:
Map and Directions
Authorized official contact:
Name: Bolden Ravenell, Tamika Michelle Doctor of Podiatric Medicine (DPM)
Phone: (916) 215-1234

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X POD 607 South Carolina

Profile Details

NPI number 1588965586
LBN Legal business name Coastal Podiatry Llc
DBA Doing business as
Authorized official Bolden Ravenell, Tamika Michelle Doctor of Podiatric Medicine (DPM)
Entity Organization
Organization subpart 1 No
Enumeration date Nov 7th, 2010
Last updated Dec 13th, 2013 - about 12 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1588965586 NPPES
South Carolina MEDICAID GP9889

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