Healthcare Provider Details

I. General information

NPI: 1528028727
Provider Name (Legal Business Name): MED CENTRAL HEALTH RESOURCES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3424 CLEMSON BLVD
ANDERSON SC
29621-1357
US

IV. Provider business mailing address

3424 CLEMSON BLVD
ANDERSON SC
29621-1357
US

V. Phone/Fax

Practice location:
  • Phone: 864-261-3022
  • Fax: 864-224-5990
Mailing address:
  • Phone: 864-261-3022
  • Fax: 864-224-5990

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JERRY M. NEAL
Title or Position: PRESIDENT
Credential: PHD.
Phone: 864-261-3022