Organization
CALBA ENTERPRISES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CATHY BAGLEY (CREDENTIALING SPECIALIST)
(843) 606-6776
Entity
Organization
Contact information
Practice address
330 ROBERT SMALLS PKWY, BEAUFORT, SC 29906-4237
(803) 747-8235
Mailing address
630 HIGHLAND ST, ORANGEBURG, SC 29115-4357
(803) 747-8235
Taxonomy
Speciality
Code
Description
License number
State
202C00000X
Independent Medical Examiner Physician
Primary
—
—
Other
Enumeration date
06/05/2018
Last updated
06/05/2018
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