Provider Demographics
NPI:1962906313
Name:CHARLESTON ONCOLOGY, PA
Entity type:Organization
Organization Name:CHARLESTON ONCOLOGY, PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACY DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:FLOYD
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:843-577-6957
Mailing Address - Street 1:2085 HENRY TECKLENBURG DR FL 2
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29414-7710
Mailing Address - Country:US
Mailing Address - Phone:843-577-6957
Mailing Address - Fax:
Practice Address - Street 1:3510 HIGHWAY 17 BYP N STE 300
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29466-8230
Practice Address - Country:US
Practice Address - Phone:843-577-6957
Practice Address - Fax:843-266-2981
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-21
Last Update Date:2020-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site