Organization
LOW COUNTRY PATHOLOGY ASSOCIATES PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. FRANCES S PUCKETT (PRESIDENT FINANCIAL DIRECTOR)
(864) 223-3070
Entity
Organization
Contact information
Practice address
9330 MEDICAL PLAZA DR, DEPARTMENT OF PATHOLOGY, N CHARLESTON, SC 29406-9104
(843) 797-4179
(843) 797-4296
Mailing address
PO BOX 49009, GREENWOOD, SC 29649-0001
(864) 223-3070
(864) 223-1396
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CC5424
RAILROAD MEDICARE
—
05
—
GP1425
—
SC
Enumeration date
03/08/2006
Last updated
05/12/2015
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