Organization
PEE DEE ANESTHESIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD C JOHNSON CRNA (PRESIDENT)
(843) 431-2000
Entity
Organization
Contact information
Practice address
2928 E HIGHWAY 76, MULLINS, SC 29574-6039
(843) 431-2000
Mailing address
PO BOX 2429, MURRELLS INLET, SC 29576-2429
(843) 651-2624
(843) 357-4940
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP0505
—
SC
Enumeration date
05/03/2006
Last updated
08/22/2020
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