Basic Information
| Provider Information | |||||||||
| NPI: | 1861667198 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ABRAMS | ||||||||
| FirstName: | CHARLES | ||||||||
| MiddleName: | RANDALL | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | RRT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6439 GARNESS FERRY RD. | ||||||||
| Address2: | |||||||||
| City: | COLUMBIA | ||||||||
| State: | SC | ||||||||
| PostalCode: | 28020 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8037764000 | ||||||||
| FaxNumber: | 8036475707 | ||||||||
| Practice Location | |||||||||
| Address1: | 6439 GARNESS FERRY RD. | ||||||||
| Address2: | |||||||||
| City: | COLUMBIA | ||||||||
| State: | SC | ||||||||
| PostalCode: | 28020 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8037764000 | ||||||||
| FaxNumber: | 8036475707 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/28/2008 | ||||||||
| LastUpdateDate: | 04/28/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2279G1100X | 3518 | SC | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Registered | General Care |
No ID Information.