Provider Demographics
NPI:1992153605
Name:PLANNED PARENTHOOD SOUTH ATLANTIC
Entity type:Organization
Organization Name:PLANNED PARENTHOOD SOUTH ATLANTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:M
Authorized Official - Last Name:LONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-833-7534
Mailing Address - Street 1:100 S BOYLAN AVE
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27603-1802
Mailing Address - Country:US
Mailing Address - Phone:919-833-7534
Mailing Address - Fax:
Practice Address - Street 1:200 RUTLEDGE AVE
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29403-5848
Practice Address - Country:US
Practice Address - Phone:843-628-4380
Practice Address - Fax:843-937-6497
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-03
Last Update Date:2016-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0050XAmbulatory Health Care FacilitiesClinic/CenterFamily Planning, Non-Surgical