Healthcare Provider Details

I. General information

NPI: 1861734725
Provider Name (Legal Business Name): THE FAR GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2013
Last Update Date: 03/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37 MALLET HILL RD
COLUMBIA SC
29223-3221
US

IV. Provider business mailing address

37 MALLET HILL RD
COLUMBIA SC
29223-3221
US

V. Phone/Fax

Practice location:
  • Phone: 803-546-6467
  • Fax:
Mailing address:
  • Phone: 803-546-6467
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License Number208D00000X
License Number StateSC

VIII. Authorized Official

Name: DR. FRANK MARVIN RUMPH SR.
Title or Position: PRESIDENT
Credential: M.D.
Phone: 803-546-6467