NPIMap

Organization Active NPI

Lowcountry Urology Clinics, PA

  • Durable Medical Equipment & Medical Supplies
  • Charleston, SC
National Provider Identifier
1184811226
Registry record updated Apr 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
34645 Issued in SC
Legal business name
LOWCOUNTRY UROLOGY CLINICS, PA
Practice address
125 Doughty Street #390
Charleston, SC 29403-5786
Phone
(843) 577-8401
NPI assigned
Oct 3, 2007
Last updated
Apr 16, 2009By the provider in NPPES
Organization subpart
Yes
Parent organization
LOWCOUNTRY UROLOGY CLINICS, PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 16, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Diane S Hader
Title
Appointed Official
Phone
(843) 577-3143

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 34645 SC Primary

Addresses

Primary practice location

125 Doughty Street #390
Charleston, SC 29403-5786

Mailing address

2687 Lake Park Drive
N. Charleston, SC 29406-9100
Phone (843) 725-4414

Other identifiers 1

IdentifierTypeStateIssuer
GP4434MedicaidSC

National Provider Directory

National Provider Directory
Tax ID family
Lowcountry Urology Clinics13 organizations share this tax ID, including this one
Part of
Lowcountry Urology Clinics

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

Locations

125 Doughty St
Ste 390
Charleston, SC 29403
Phone (843) 577-2160

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1191369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239840000000",
    "number": "1184811226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2687 LAKE PARK DRIVE",
            "city": "N. CHARLESTON",
            "state": "SC",
            "postal_code": "294069100",
            "telephone_number": "843-725-4414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 DOUGHTY STREET #390",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294035786",
            "telephone_number": "843-577-8401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOWCOUNTRY UROLOGY CLINICS, PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LOWCOUNTRY UROLOGY CLINICS, PA",
        "enumeration_date": "2007-10-03",
        "last_updated": "2009-04-16",
        "status": "A",
        "authorized_official_last_name": "HADER",
        "authorized_official_first_name": "DIANE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "APPOINTED OFFICIAL",
        "authorized_official_telephone_number": "843-577-3143"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "SC",
            "license": "34645",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP4434",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.