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Organization

VETERAN'S ADMINISTRATION

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JAMIE CODY (MCCR SUPERVISOR)
(843) 789-6352
Entity
Organization

Contact information

Practice address
109 BEE ST, CHARLESTON, SC 29401-5703
(843) 789-6352
Mailing address
2154 COUNTRY MANOR DR, MT PLEASANT, SC 29466-7448

Taxonomy

Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
827569
SC

Other

Enumeration date
12/27/2007
Last updated
12/27/2007
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