Provider Demographics
NPI:1316946106
Name:CHARLESTON ENDOSCOPY CENTER
Entity type:Organization
Organization Name:CHARLESTON ENDOSCOPY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING AND CODING SUPERVISOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:SEARSON
Authorized Official - Suffix:
Authorized Official - Credentials:CPC, MCS-P
Authorized Official - Phone:843-722-8000
Mailing Address - Street 1:2001 2ND AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29486-7887
Mailing Address - Country:US
Mailing Address - Phone:843-793-5182
Mailing Address - Fax:843-266-5125
Practice Address - Street 1:1962 CHARLIE HALL BLVD
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29414-5837
Practice Address - Country:US
Practice Address - Phone:843-722-8000
Practice Address - Fax:843-723-7850
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-14
Last Update Date:2020-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCASF079261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCASC050Medicaid
SCY03489Medicare UPIN