Provider Demographics
NPI:1972754851
Name:HYPERBARICS OF RALEIGH
Entity type:Organization
Organization Name:HYPERBARICS OF RALEIGH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:C
Authorized Official - Last Name:KLINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-681-1811
Mailing Address - Street 1:200 MERCHANT ST
Mailing Address - Street 2:
Mailing Address - City:HILTON HEAD
Mailing Address - State:SC
Mailing Address - Zip Code:29926-1649
Mailing Address - Country:US
Mailing Address - Phone:843-681-1811
Mailing Address - Fax:843-689-7150
Practice Address - Street 1:8300 HEALTH PARK
Practice Address - Street 2:SUITE 134
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-4730
Practice Address - Country:US
Practice Address - Phone:919-846-9882
Practice Address - Fax:919-846-9842
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-09
Last Update Date:2009-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207PE0005XAllopathic & Osteopathic PhysiciansEmergency MedicineUndersea and Hyperbaric MedicineGroup - Single Specialty