Organization
MUSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JODI ALLEN (PROGRAM COORDINATOR)
(843) 792-2731
Entity
Organization
Contact information
Practice address
171 ASHLEY AVE, CHARLESTON, SC 29425-0001
(843) 792-1414
Mailing address
7094 WINDMILL CREEK RD, CHARLESTON, SC 29414-7574
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
LL28072
SC
Other
Enumeration date
11/02/2006
Last updated
08/22/2020
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