Provider Demographics
NPI:1427799964
Name:COSMASCARE
Entity type:Organization
Organization Name:COSMASCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:LAWRENCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-724-1299
Mailing Address - Street 1:1320 MAIN ST STE 345
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29201-3204
Mailing Address - Country:US
Mailing Address - Phone:803-724-1299
Mailing Address - Fax:803-724-1305
Practice Address - Street 1:1320 MAIN ST STE 345
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-3204
Practice Address - Country:US
Practice Address - Phone:803-724-1299
Practice Address - Fax:803-724-1305
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-06
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty