Healthcare Provider Details

I. General information

NPI: 1457399396
Provider Name (Legal Business Name): THE FAMILY HEALTHCARE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23013 HIGHWAY 76 E
CLINTON SC
29325-7530
US

IV. Provider business mailing address

PO BOX 30
CLINTON SC
29325-0030
US

V. Phone/Fax

Practice location:
  • Phone: 864-833-5986
  • Fax: 864-833-3987
Mailing address:
  • Phone: 864-833-5986
  • Fax: 864-833-3987

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ENOCH G ULMER JR.
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 864-833-5986