Provider Demographics
NPI:1972576536
Name:CSC ACQUISITION, LLC
Entity type:Organization
Organization Name:CSC ACQUISITION, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:JIM
Authorized Official - Middle Name:C
Authorized Official - Last Name:CHOW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:803-779-7316
Mailing Address - Street 1:3600 FOREST DR STE 400
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29204-4057
Mailing Address - Country:US
Mailing Address - Phone:803-779-7316
Mailing Address - Fax:803-343-2538
Practice Address - Street 1:3600 FOREST DR STE 400
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29204-4057
Practice Address - Country:US
Practice Address - Phone:803-779-7316
Practice Address - Fax:803-343-2538
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-13
Last Update Date:2021-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
No207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic SurgeryGroup - Single Specialty
No207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathologyGroup - Single Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC7480Medicare ID - Type Unspecified
SC7481Medicare ID - Type Unspecified
SC7479Medicare ID - Type Unspecified