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Organization
HOPE CLINIC LLC
Active
Organization
HOPE CLINIC LLC
Active
Parent organization
HOPE CLINIC LLC
Other names
Hope Clinic - North Charleston
Organization subpart
Yes
Provider details
NPI number
Legal business name
HOPE CLINIC LLC
Authorized official
DR. TEMISAN L ETIKERENTSE M.D (MEDICAL DOCTOR, CEO)
(843) 725-4673
Entity
Organization
Contact information
Practice address
5880 RIVERS AVE, NORTH CHARLESTON, SC 29406
(843) 725-4673
(843) 725-1235
Mailing address
5880 RIVERS AVE, NORTH CHARLESTON, SC 29406-6053
(843) 725-4673
(843) 725-1235
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
20234
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20067813-001
FIRST CHOICE
SC
01
—
20234
STATE LICENSE
SC
01
—
75767
SC PCF
SC
05
—
GP4815
—
SC
01
—
JB021584
JUA
SC
Enumeration date
11/23/2007
Last updated
03/07/2023
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