NPIMap

Organization Active NPI

Lowcountry Ambulatory Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Charleston, SC
National Provider Identifier
1639433956
Registry record updated Jul 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
SC-11-48 Issued in SC
Legal business name
LOWCOUNTRY AMBULATORY CENTER, LLC
Practice address
641 Saint Andrews Blvd
Charleston, SC 29407-7165
Phone
(843) 766-4070
Fax
(843) 766-0633
NPI assigned
Jul 2, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2012

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

Authorized official

Name
Mr. Eric E Radabaugh, MBA
Title
Ceo
Phone
(843) 766-4070

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X SC-11-48 SC Primary

Addresses

Primary practice location

641 Saint Andrews Blvd
Charleston, SC 29407-7165

Mailing address

641 Saint Andrews Blvd
Charleston, SC 29407-7165
Phone (843) 766-4070

National Provider Directory

National Provider Directory
Tax ID family
Ability Network2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

NPI Registry JSON

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

{
    "created_epoch": "1341187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1341187200000",
    "number": "1639433956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "641 SAINT ANDREWS BLVD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294077165",
            "telephone_number": "843-766-4070",
            "fax_number": "843-766-0633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "641 SAINT ANDREWS BLVD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294077165",
            "telephone_number": "843-766-4070",
            "fax_number": "843-766-0633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOWCOUNTRY AMBULATORY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-02",
        "last_updated": "2012-07-02",
        "status": "A",
        "authorized_official_last_name": "RADABAUGH",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "843-766-4070",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "SC",
            "license": "SC-11-48",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jul 2, 2012; 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.