Organization
PAIN MANAGEMENT ASC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BETH GOLD (PRACTICE MANAGER)
(843) 681-5062
Entity
Organization
Contact information
Practice address
11 HOSPITAL CENTER CMNS, SUITE 100, HILTON HEAD, SC 29926-2844
(843) 681-5062
(843) 681-5063
Mailing address
PO BOX 22120, HILTON HEAD, SC 29925-2120
(843) 681-5062
(843) 681-5063
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
15288
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
42D1094640
CLIA
SC
05
—
GP3893
—
SC
Enumeration date
07/27/2006
Last updated
02/22/2018
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