Healthcare Provider Details

I. General information

NPI: 1477866960
Provider Name (Legal Business Name): ON CALL MEDICAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2010
Last Update Date: 11/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

535 FOREST SHOALS LN
DUNCAN SC
29334-8841
US

IV. Provider business mailing address

1740 WOODRUFF RD
GREENVILLE SC
29607-5933
US

V. Phone/Fax

Practice location:
  • Phone: 864-266-0067
  • Fax:
Mailing address:
  • Phone: 864-458-9288
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code293D00000X
TaxonomyPhysiological Laboratory
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: SUSAN WORKMAN
Title or Position: OWNER
Credential:
Phone: 864-458-9288