Organization
CHARLESTON ENT ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CASEY WILSON (HR ADMINISTRATOR)
(843) 766-7103
Entity
Organization
Contact information
Practice address
9185 UNIVERSITY BLVD, NORTH CHARLESTON, SC 29406-9120
(843) 766-7103
(843) 402-6840
Mailing address
2295 HENRY TECKLENBURG DR, CHARLESTON, SC 29414-7801
(843) 766-7103
(843) 402-6840
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
—
—
Other
Enumeration date
04/14/2015
Last updated
04/14/2015
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