Individual
MR. SAMUEL JENKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RRT
Contact information
Practice address
109 BEE ST, CHARLESTON, SC 29401-5703
(843) 577-5011
Mailing address
1422 HAYNES ST, ORANGEBURG, SC 29115-7911
(803) 533-1004
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
227900000X
—
SC
Enumeration date
08/08/2013
Last updated
08/08/2013
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