Provider Demographics
NPI:1306650932
Name:SOUTH CAROLINA INTEGRATIVE HEALTH INC.
Entity type:Organization
Organization Name:SOUTH CAROLINA INTEGRATIVE HEALTH INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TREAYOR
Authorized Official - Middle Name:WESLEY
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:843-806-9402
Mailing Address - Street 1:1807 CROWNE COMMONS WAY STE F8
Mailing Address - Street 2:
Mailing Address - City:JOHNS ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29455-4931
Mailing Address - Country:US
Mailing Address - Phone:843-806-9402
Mailing Address - Fax:
Practice Address - Street 1:1807 CROWNE COMMONS WAY STE F8
Practice Address - Street 2:
Practice Address - City:JOHNS ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29455-4931
Practice Address - Country:US
Practice Address - Phone:843-806-9402
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-04
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center