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Organization

LOWCOUNTRY UROLOGY CLINICS, PA

Active
Parent organization
LOWCOUNTRY UROLOGY CLINICS. PA
Organization subpart
Yes

Provider details

NPI number
Legal business name
LOWCOUNTRY UROLOGY CLINICS. PA
Authorized official
MS. DIANE S HADER (OFFICIAL DELIGATE)
(843) 284-4267
Entity
Organization

Contact information

Practice address
641 SAINT ANDREWS BLVD, CHARLESTON, SC 29407-7165
(843) 766-9747
Mailing address
2687 LAKE PARK DR, NORTH CHARLESTON, SC 29406-9100
(843) 725-4414

Taxonomy

Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
34652
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
GP4437
SC
Enumeration date
09/25/2007
Last updated
03/30/2026
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