Organization
SOUTH CAROLINA HEALTH SERVICES
Active
Other names
Bluffton Okatie Outpatient Center
Organization subpart
No
Provider details
NPI number
Authorized official
TERRI-MARIE MAHONEY RN (DIRECTOR)
(843) 705-8823
Entity
Organization
Contact information
Practice address
40 OKATIE CENTER BLVD, SUITE 125, OKATIE, SC 29909-7507
(843) 705-8804
(843) 705-8950
Mailing address
PO BOX 403615, ATLANTA, GA 30385-0001
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
ASF-075
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ASC246
—
SC
01
—
P00112549
RAILROAD MEDICARE
SC
Enumeration date
01/25/2007
Last updated
08/22/2020
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