Healthcare Provider Details

I. General information

NPI: 1942598735
Provider Name (Legal Business Name): CAROLINA PEDIATRICS AND ADOLESCENT CARE, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2011
Last Update Date: 07/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2113 ADAMS GRV STE. 103
COLUMBIA SC
29203-6951
US

IV. Provider business mailing address

2113 ADAMS GRV STE. 103
COLUMBIA SC
29203-6951
US

V. Phone/Fax

Practice location:
  • Phone: 803-256-0531
  • Fax: 888-318-5567
Mailing address:
  • Phone: 803-256-0531
  • Fax: 888-318-5567

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number
License Number State

VIII. Authorized Official

Name: MARGIE LAMBRIES
Title or Position: PHARMACY MANAGER
Credential:
Phone: 803-256-0531